PREVENTION OF CARDIOVASCULAR DISEASE IN DIABETES MELLITU

大多数糖尿病患者死于心血管疾病（CVD），糖尿病患者的CVD率是非糖尿病人群的2至4倍。这种增加的CVD风险，沿着美国人口中肥胖症患病率的增加和老年人数量的增加，意味着糖尿病相关的CVD将来将成为更大的公共卫生问题。糖尿病是一种复杂的代谢紊乱，具有通常评估的胰岛素抵抗水平和可变的循环胰岛素水平，其通常伴有碳水化合物、脂质和蛋白质代谢的异常以及血压升高。虽然血糖控制对2型患者很重要，但关键是不要忽视相关CVD危险因素异常的治疗。在2型糖尿病患者中，强化控制已确定的CVD风险因素（血压和血脂）和强化控制血糖对预防心血管疾病事件的影响尚不清楚。该研究是一项多中心随机临床试验，对约10，000名2型糖尿病成年患者进行了4至7年的随访。本研究项目的主要目的是评估是否可以通过以下方式降低重大心血管疾病事件的发生率：（1）与常规控制相比，强化控制血糖;（2）与常规控制相比，强化控制血压;（3）与常规控制相比，强化控制血脂。其他目标包括上述干预措施的比较成本效益及其对与健康有关的生活质量的影响。

Most diabetic patients die of cardiovascular disease (CVD), with CVD rates in diabetic persons two to four times those of the non-diabetic population. This increased CVD risk, along with the increasing prevalence of obesity and increasing numbers of elderly in the U.S. population, means that diabetes-associated CVD will become an even greater public health problem in the future. Diabetes mellitus is a complex metabolic disorder with generally evaluated levels of insulin resistance and variable levels of circulating insulin, which is often accompanied by abnormalities in carbohydrate, lipid, and protein metabolism and elevated blood pressure. While glucose control appears important for Type 2 patients, it is critical not to overlook treatment of associated CVD risk factor abnormalities. The effects on prevention of cardiovascular disease events of intensive control of established CVD risk factors (blood pressure and blood lipids), and intensive control of blood glucose, in Type 2 diabetes are unknown. The study is a multi-center randomized clinical trial of about 10,000 adult patients with Type 2 diabetes mellitus followed for four to seven years. The primary objective of this research program is to assess whether the rate of major cardiovascular disease events can be reduced by: (1) intensive control of blood sugar compared with conventional control; (2) intensive control of blood pressure compared with conventional control; and (3) intensive control of blood lipids compared with conventional control. Other objectives include the comparative cost effectiveness of the above interventions and their impact on health-related quality of life.