Afzal Qasim, Muhammad Inam Qureshi, Darshan Kumar, Muhammad Umar Khan.
Coronary heart disease together with diabetes poses a serious health threat.
Gomal J Med Sci Jan ;13(4):246-9.

Among various risk factors, the most important is diabetes and its prime form, type 2 diabetes mellitus (T2DM), and has idiosyncratic connection with coronary heart disease (CHD). Diabetes patients have two- to four-fold higher threat of developing coronary disease than the people without diabetes, and cardio-vascular disease (CVD) is responsible for an irresistible 65-75 per cent of deaths in people with diabetes. Moreover considerably the age and sex-adjusted mortality risk in diabetic patients without pre-existing coronary artery disease was found to be equal to that of non-diabetic individuals with prior myocardial infarction (MI). These incredible results concerning higher risk of mortality have led to doubt that widespread precursors predispose to diabetes and CHD with subsequent implications that insulin resistance, visceral adiposity, and excess inflammation cause the pathophysiology of thrombogenesis. In addition, a complex mix of mechanistic processes such as oxidative stress, enhanced atherogenecity of cholesterol particles, abnormal vascular reactivity, augmented haemostatic activation, and renal dysfunction have been proposed as features characteristic of T2DM that may confer excess risk of coronary heart disease.

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