Type 2 diabetes mellitus: ‘the silent killer’

Type 2 diabetes mellitus (DM) is best regarded as a cluster of cardiovascular risk factors contributing to accelerating atherosclerotic (macrovascular) disease, often present for many years before the onset of clinical diabetes. It is better referred to as the metabolic syndrome or insulin resistance syndrome, leading to premature cardiovascular death, unless aggressive risk factor reduction targeting blood glucose, blood pressure, dyslipidaemia and the pro‐coagulant state is implemented. As type 2 DM is expected to double world‐wide over the next 25 years, the burden of type 2 DM presents a major challenge to health authorities to improve the prognosis of those subjects with type 2 DM. It is not a ‘mild disease’ but rather a ‘silent killer’.