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Type 2 Diabetes Mellitus, A State Of Relative Insulin Deficiency Essay

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Type 2 diabetes mellitus, a state of relative insulin deficiency with underlying insulin resistance, accounts for majority of the cases of hyperglycemia worldwide. An estimated 422 million people worldwide have diabetes [1], and this number is expected to reach 592 million by the year 2035 [2]. Almost 30 million Americans (9% of the population) have diabetes, with estimated total health care costs of $245 billion due to extensive complications, primarily micro- and macrovascular pathology.

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death among individuals with type 2 diabetes, in whom adverse cardiovascular outcomes occur, on average, 14.6 years earlier [5] and with increased severity compared to individuals without diabetes mellitus. People with type 2 diabetes have twofold-increased risk of developing ASCVD [6]. The increment in the diabetic population with cardiovascular events reflects the steady increase in the number of older individuals in the United States and the improved survival of individuals with diabetes. Prevalence of obesity, which is related to risk for ASCVD and diabetes, is also on an upsurge in the United States as well as globally.

Guidelines from the American Heart Association (AHA)/American Diabetes Association (ADA) [7] and the European Society of Cardiology [8] present different recommendations for individuals with diabetes depending on an individual 's risk profile. To identify patients who will benefit most from

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