ABSTRACT:
Since cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with diabetes, this is a critical topic for any clinical review. Here is a concise abstract and a set of keywords tailored for this subject. Abstract Diabetes mellitus is a major independent risk factor for a spectrum of cardiovascular complications, including coronary artery disease, heart failure, and peripheral arterial disease. This abstract examines the pathophysiological interplay between chronic hyperglycemia, insulin resistance, and cardiovascular damage. Central to this relationship is the promotion of accelerated atherosclerosis through oxidative stress, chronic inflammation, and endothelial dysfunction. The clinical landscape of diabetic cardiovascular risk has shifted from a glucose-centric model to a comprehensive risk-reduction strategy. While managing traditional factors like hypertension and dyslipidemia remains essential, recent cardiovascular outcome trials (CVOTs) have revolutionized the standard of care. The integration of SGLT2 inhibitors and GLP-1 receptor agonists has demonstrated profound benefits in reducing major adverse cardiovascular events (MACE) and heart failure hospitalizations, independent of their glucose-lowering effects. This review highlights the necessity of early screening for subclinical atherosclerosis and the implementation of a multidisciplinary approach—combining intensive lifestyle modifications with modern pharmacotherapy—to mitigate the significant cardiovascular burden associated with diabetes.