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Diabetes Brings
Earlier Heart Disease, Death
Developing the
type 2 form of the illness is like aging 15 years, researchers say
By Ed Edelson
HealthDay Reporter
(HealthDay News)
-- People with type 2 diabetes can expect to suffer from fatal and
non-fatal heart attacks, strokes and other cardiovascular events
about 15 years earlier than non-diabetics, a new study shows.
"The rates are
consistently higher," said lead researcher Dr. Gillian Booth, an
adjunct scientist at the
Her team
published its findings in the July 1 issue of The Lancet.
It's long been
known that type 2 diabetes increases the risk for cardiovascular
disease. In the study, Booth's team studied the hospital and death
records of nearly 9.5 million Canadians -- 379,000 of them with
diabetes. They hoped to determine how fast diabetes accelerates an
individual's progression to higher levels of risk for cardiovascular
disease.
The study found
that men with type 2 diabetes entered the cardiovascular
"moderate-risk" category at an average age of just under 39 years;
for non-diabetic men, that transition didn't typically occur until
more than 15 years later, at about age 55. Diabetic men entered the
"high-risk" category at just over 49 years of age, compared to 62
years for men without diabetes, the researchers found.
The numbers for
women were similar. Women with type 2 diabetes were classified as
being at moderate risk for heart disease at an average age of 46,
compared to 62 years for non-diabetic women. And women with type 2
diabetes entered the high-risk category at 56 years, compared to
just under 69 years of age for women without diabetes.
Perhaps the
most striking numbers in the report involved life expectancy. People
with type 2 diabetes who were also classified as being at moderate
or high risk for cardiovascular disease died an average of about 18
years earlier than non-diabetics, the researchers found.
"This report is
a call to action to physicians to be aggressive in identifying
patients and helping them by telling them to be more physically
active and watch their weight," said Dr. V.S. Srinivas, an
interventional cardiologist at
The report
"underscores the importance of identifying diabetics early on," he
said. Srinivas believes physicians should be on the alert for
persons at high risk of developing type 2 diabetes and intervene
early.
The study
indicates that intervention at an early age is a good strategy,
Booth added.
"Under 40,
people with diabetes seem to have a low-to-moderate absolute risk of
cardiovascular disease," she said. "So at that age, it makes sense
to individualize treatment."
Srinivas said
efforts at prevention could well start even earlier, with
educational programs for children on the risks of diabetes.
The study
covered only type 2 diabetes -- the kind that generally begins in
the adult years, often due to being overweight and lack of exercise,
Booth noted. An estimated 16 million to 18 million Americans have
type 2 diabetes, triple the number 30 years ago, due in large part
to the upsurge in obesity. People who are obese -- defined as a body
mass index (BMI) of 30 or greater -- have a five-fold greater risk
of type 2 diabetes than those with a normal BMI of 25 or less,
according to the National Institutes of Health.
In type 2
diabetes, either the body does not produce enough insulin or the
cells ignore the insulin, a hormone that converts blood sugar to
energy for cells.
The study did
not look at the effects of type 1 diabetes, an autoimmune disease in
which the insulin-producing beta cells of the pancreas are
destroyed. "We need to do work about that," Booth said.
More
information
Find out much
more about diabetes at the
American Diabetes Association.
SOURCES: Gillian Booth, M.D., adjunct scientist, Institute of Clinical Evaluative Sciences, Toronto, Canada; V. S. Srivinas, M.D., interventional cardiologist, Montefiore Medical Center, New