Type 2 diabetes mellitus and cardiovascular disease in Spain: A narrative review

Introduction. In spite of having a high prevalence of diabetes mellitus the prevalence of ischemic heart disease is low in Spain. Methods. A narrative review of the bibliography was performed to search for potential particularities in the epidemiology, pathogenecity, and care of diabetes mellitus in Spain. Results. The age-adjusted prevalence of diabetes in Spain is close to 10% (90% type 2) ranging from 6.1% to 13.3% (higher in Canary Islands), with an increased North-to-South gradient. Men have a 27%-42% higher prevalence than women. The incidence ranges from 5 to 8 cases per 1000 inhabitants-year. Spanish patients with diabetes have similar incidences and prevalences of cardiovascular complications and related mortality compared with those reported in other countries. Several studies have shown a consistent underuse of preventive therapies both in patients with and without cardiovascular diseases, and low rates of achievement of therapeutic goals. Despite their much worse prognosis, and contrary to current recommendations, diabetic patients with acute vascular events are not treated differently compared with non-diabetics. Conclusions. The age-adjusted prevalence and incidence estimates of diabetes mellitus in Spain appear to be similar to those in high-incidence countries. Diabetic patients show a high cardiovascular risk profile but the control of risk factors is poor, particularly in women and in patients with established cardiovascular disease. Initial and later care of diabetic patients with acute vascular events in Spain is far away from optimal. There is a huge opportunity for improving cardiovascular prevention and care in diabetic patients with and without cardiovascular disease in Spain.

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