Allan D. Sniderman, MD; Thea Scantlebury, BSc; Katherine Cianflone, PhD
Acknowledgments: The authors thank Dr. J. Wiseman, an academic clinical internist, for encouragement and support.
Grant Support: By grant MT-5480 from the Medical Research Council of Canada (Dr. Sniderman). Ms. Scantlebury is a recipient of the Medical Research Council of Canada Doctoral Research Award (9810DRN-1414-58633). Dr. Cianflone is a recipient of a scholarship from the Fonds de la Recherche en Santé du Québec.
Requests for Single Reprints: Allan D. Sniderman, MD, Mike Rosenbloom Laboratory for Cardiovascular Research, Room H7.22, McGill University Health Centre, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, Quebec H3A 1A1, Canada; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Sniderman: Mike Rosenbloom Laboratory for Cardiovascular Research, Room H7.22, McGill University Health Centre, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, Quebec H3A 1A1, Canada.
Ms. Scantlebury and Dr. Cianflone: Royal Victoria Hospital, 687 Pine Avenue West, Montreal, Quebec H3A 1A1, Canada.
Sniderman AD, Scantlebury T, Cianflone K. Hypertriglyceridemic HyperapoB: The Unappreciated Atherogenic Dyslipoproteinemia in Type 2 Diabetes Mellitus. Ann Intern Med. 2001;135:447-459. doi: 10.7326/0003-4819-135-6-200109180-00014
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Published: Ann Intern Med. 2001;135(6):447-459.
Worldwide, more than 100 million people have type 2 diabetes mellitus, and that number will more than double in the next 10 years (1). Of these persons, more than three of four—that is, more than 150 million people—are expected to die of cardiovascular disease over the next decade (2). A history of diabetes is equivalent in risk for death to a history of myocardial infarction, and the combination compounds the risk (3).
For some time, the hope has been that better control of glucose would substantially reduce the risk for vascular disease. To date, however, that has not been the case. The United Kingdom Prospective Diabetes Study found that better control reduced the frequency of microvascular disease, but the trend toward a reduced frequency of macrovascular disease was not statistically significant (4). In addition, the frequency of macrovascular disease in patients with type 2 diabetes varies geographically (5), suggesting that factors other than diabetes play an important role in the pathogenesis of the vascular disease.
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