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Abstract
The prevalence of diabetes mellitus is fairly increasing, there will be diabetes breakout in the coming few years, the total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million
in 2030,the number of people with diabetes is increasing due to, population growth, aging, urbanization, and increasing prevalence of obesity and physical inactivity, quantifying the prevalence of diabetes and the number of people affected by diabetes, now and in the future is important to allow rational planning and allocation of resources, diabetes epidemic will continue even if levels of obesity remain constant. (102) Diabetes is a major cardiovascular risk factor, it often leads to severe cardiovascular complications, and coronary artery disease (CAD) is the main cause of death in diabetic patients, 65% of type II diabetic patients die from cardiovascular causes. (103) Silent myocardial ischemia is more frequent in diabetic patients, the progress made in detection and treatment of CAD allows reconsidering the screening of silent myocardial ischemia, in the hope that early CAD diagnosis leads to a more effective therapy and the decrease of
cardiovascular complications and mortality. (104) Silent myocardial ischemia is a troublesome problem for the clinician, it is an iceberg, a small amount is readily visible but much more remains hidden from view in the absence of evidence-based guidelines for treatment many questions arise including how often should it be sought and what should be done about it when found.