Researchers have identified a link between type 2 diabetes and cardiovascular health issues — even in people with optimally controlled cardiovascular risk factors.
In a new study, scientists have discovered a link between type 2 diabetes and an increased risk of cardiovascular issues, even for people who optimally control the common risk factors for cardiovascular disease.
The research, which appears in the journal Circulation, suggests that early treatment of people with type 2 diabetes for cardiovascular disease may significantly reduce cardiovascular events and mortality.
Type 2 diabetes and heart health
According to the Centers for Disease Control and Prevention (CDC), 1 in 10 people in the United States have diabetes, and of those, 90–95% have type 2 diabetes.
The cells of a person with type 2 diabetes do not react to insulin in the way they should. A person’s pancreas produces insulin, which enables the sugar carried by the bloodstream to enter the cells of the body.
Because blood sugar is not being removed from a person’s bloodstream, their blood sugar levels can increase to dangerous levels. According to the CDC, this can cause vision loss, kidney disease, and heart disease.
Researchers have shown that having type 2 diabetes increases a person’s risk of developing both non-fatal and fatal forms of cardiovascular disease.
Studies also state that people with type 2 diabetes who optimally control common cardiovascular risk factors can reduce their chances of developing cardiovascular events. The authors of the new Circulation study cite research showing that this may prolong a person’s life by up to 8 years.
According to the CDC, risk factors for cardiovascular disease include high blood pressure, high cholesterol, smoking, obesity, an unhealthy diet, low physical activity, and diabetes.
Researchers suggest that people who optimally manage their cardiovascular risk factors could completely negate the associated risk between type 2 diabetes and cardiovascular disease.
In the present article, the researchers wanted to see if this latter study’s findings, conducted with a Swedish population, were reproducible in a population from the United Kingdom.
According to Dr. Alison Wright, first author of the study and research associate at the Centre for Pharmacoepidemiology and Drug Safety at the University of Manchester, U.K., “[p]revious studies have shown that people with type 2 diabetes had little or no excess risk of cardiovascular disease events or death when all risk factors are optimally controlled.”
“Our team sought to determine how the degree of risk factor control in people with type 2 diabetes impacted cardiovascular disease risk and mortality, compared to people with type 2 diabetes who had all risk factors optimally controlled and to people who do not have type 2 diabetes.”
Large observational study
To go about this, the researchers looked at clinical data gathered during 2006–2015. The data included over 101,000 people with type 2 diabetes. The team matched these with another group of almost 331,000 people with type 2 diabetes, as well as a group of nearly 379,000 without type 2 diabetes.
Following U.K. clinical guidelines, the researchers looked at five cardiovascular risk factors: cholesterol, triglycerides, smoking, blood glucose, and blood pressure.
They looked particularly at the association between optimally controlling these risk factors and cardiovascular events or mortality in people with type 2 diabetes, compared with people who did not have the condition.
The researchers found that even when optimally controlling the five risk factors for cardiovascular issues, people with type 2 diabetes still had a 21% increased risk of developing cardiovascular disease compared with those without type 2 diabetes.
They also had a 31% increased risk of hospitalization due to heart failure.
For Dr. Wright, the findings suggest that early intervention in cardiovascular risk for people with type 2 diabetes is important:
“People with type 2 diabetes should be treated for cardiovascular risk factors as early as possible, regardless of whether they have cardiovascular disease or not.
“There is real potential here to reduce the overall impact of type 2 diabetes on future cardiovascular events, especially for patients with type 2 diabetes who have not yet been diagnosed with cardiovascular disease.”
The researchers also discovered that people with type 2 diabetes tended to have poor management of cardiovascular risk factors, which scientists note is an international issue, following recent research.
In the present study, only 6% of the participants with type 2 diabetes were optimally managing their risk factors.
As a consequence, Dr. Wright and her co-authors also suggest that “[g]reater use of guideline-driven care, clinical decision support, drug intervention, and self-management support should be encouraged.”
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