- Cardiovascular Risk/Epidemiology
- Management of Cardiovascular Risk in Perimenopausal Women with Diabetes
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Catherine Kim
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Diabetes Metab J. 2021;45(4):492-501. Published online July 30, 2021
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DOI: https://doi.org/10.4093/dmj.2020.0262
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Graphical Abstract
Abstract
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- Cardiovascular disease is the primary cause of mortality in women and men with diabetes. Due to age and worsening of risk factors over the menopausal transition, risk of coronary heart disease events increases in postmenopausal women with diabetes. Randomized studies have conflicted regarding the beneficial impact of estrogen therapy upon intermediate cardiovascular disease markers and events. Therefore, estrogen therapy is not currently recommended for indications other than symptom management. However, for women at low risk of adverse events, estrogen therapy can be used to minimize menopausal symptoms. The risk of adverse events can be estimated using risk engines for the calculation of cardiovascular risk and breast cancer risk in conjunction with screening tools such as mammography. Use of estrogen therapy, statins, and anti-platelet agents can be guided by such calculators particularly for younger women with diabetes. Risk management remains focused upon lifestyle behaviors and achieving optimal levels of cardiovascular risk factors, including lipids, glucose, and blood pressure. Use of pharmacologic therapies to address these risk factors, particularly specific hypoglycemic agents, may provide some additional benefit for risk prevention. The minimal benefit for women with limited life expectancy and risk of complications with intensive therapy should also be considered.
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Citations
Citations to this article as recorded by
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- Gestational Diabetes Mellitus in Korean Women: Similarities and Differences from Other Racial/Ethnic Groups
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Catherine Kim
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Diabetes Metab J. 2014;38(1):1-12. Published online February 19, 2014
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DOI: https://doi.org/10.4093/dmj.2014.38.1.1
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3,907
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Abstract
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Gestational diabetes mellitus (GDM) reflects defects in insulin secretion in response to the metabolic demands of pregnancy. While GDM is increasingly common worldwide due in large part to the obesity epidemic, its frequency is relatively low in Korean women. In this report, the prevalence and risk factors for GDM, perinatal outcomes, and postpartum course are compared in non-Korean and Korean women. While Koreans and non-Koreans with GDM share pathophysiology and complications, there may be differences in the role of obesity and thus the effectiveness of interventions targeting obesity in GDM women. Further investigations of the effectiveness of weight loss interventions and pharmacotherapy specifically among Korean women are needed. Dietary and other lifestyle data from Korean populations could inform prevention and treatment strategies in other countries which suffer from significantly higher prevalences of GDM.
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Citations
Citations to this article as recorded by
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