Abstract
Diabetes is one of the largest global non-communicable epidemic of the 21st century. In 2017, the International Diabetes Federation (IDF) reported a prevalence of 415 million adults aged 20-79 years and estimated that it could affect almost 700 million people by 2045. Moreover, over 350 million adults are currently at high risk of developing type 2 diabetes.
In Pakistan, a recent National Diabetes Survey 2016-2017, showed that more than 26% population of Pakistan is suffering from type 2 diabetes, which means that around 35 to 38 million Pakistanis above the age of 20 years have diabetes, while 14.47% of people have pre-diabetes.2
Management of diabetes is constantly evolving. Intensification of diabetes control has proven benefits in the reduction of microvascular complications, while reduction in macrovascular complications, like Cardiovascular diseases, remaines controversial. However, in recent years, several important clinical trials have changed the way, diabetes was treated. After the results of ACCORD and ADVANCE trials, a tight control of diabetes can result in harm rather than the benefit. Secondly, cardiovascular safety of ant-diabetic drugs, have also become a major concern. US FDA has made a mandatory requirement for all new drugs to have a proven cardiovascular safety before their approval.

Key words: Diabetes mellitus,microvascular complications, macrovascular complications