A number of clinical trials have demonstrated improvement in CVD risk factors with weight loss in patients with type 2 diabetes. However, intensive long-term intervention with lifestyle modification and behavioral and pharmacologic treatment is needed to achieve and maintain weight loss, which has shown to be too challenging and/or too exhausting for patients.

The author explains that pathophysiology, including the role of hormones besides insulin, coupled with an increased awareness of emerging treatment options, can lead to improved outcomes for CVD risk. Clinicians should also recognize that incretin therapies effectively lower glucose levels without increasing weight. With the absence of a superior antihyperglycemic therapy, patients ™ personal health factors should be examined as well as their type 2 diabetes background, to meet a customized management plan that will successfully lower their chance of developing CVD while maintaining target blood glucose levels.

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