It has been estimated that in the year 2010 there will be more than 220 million patients with diabetes mellitus worldwide. About 90% of these patients will have diabetes mellitus type 2. In the Netherlands, it is expected that the number of patients will have doubled to 500.000 patients. Type 2 diabetes is associated with high morbidity and mortality from macro- and microvascular complications. Atherosclerosis is the cause of death in 75-80% of adults with type 2 diabetes. At diagnosis, 30% of the patients have already some evidence of established coronary heart disease. Diabetes itself is a strong, independent risk factor for death from cardiovascular disease, and besides hyperglycemia, specific diabetic risk factors like endothelial dysfunction, glycation of proteins, and coa,oulation abnormalities may contribut. Several other atherosclerotic risk factors are combined in type 2 diabetes, like dyslipidemia, hypertension and obesity.

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H. Jansen (Hans)
Erasmus University Rotterdam
Financial support by Pfizer, Novo Nordisk. MSD, Aventis Pharma, Lilly, Sanofi-Synthelabo, GlaxoSmithKline Beecham, AstraZeneca and the Dutch Diabetes Fund for the publication of this thesis is gratefully acknowledged
Erasmus MC: University Medical Center Rotterdam

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