|
Diabetes Leads to Higher Risk for Cardiovascular Problems
Persons with type 2 diabetes may experience a fatal or non-fatal heart attack, stroke, or other cardiovascular event about 15 years earlier than those who do not have diabetes, according to a report in the journal The Lancet.
"The rates are consistently higher," says lead researcher Dr. Gillian Booth, at the Institute of Clinical Evaluative Sciences in Toronto, Canada.
The study covered only type 2 diabetes - the type that generally begins in the adult years. This is often due to being overweight and lack of exercise, explains Dr. Booth.
About 16 million to 18 million Americans have type 2 diabetes, triple the number from 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 (NIH).
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," says Dr. Booth.
It has long been known that type 2 diabetes increases the risk for cardiovascular disease. In the study, Dr. 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 men without diabetes, that transition did not typically occur until more than 15 years later, at about age 55.
Men with type 2 diabetes entered the "high-risk" category at just over age 49, 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 women without diabetes.
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.
Some of the most striking numbers in the report pointed to life expectancy.
Persons 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 than persons who did not have diabetes.
"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," says Dr. V.S. Srinivas, at Montefiore Medical Center.
The report "underscores the importance of identifying diabetics early on," he notes.
Dr. 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, Dr. Booth adds.
"Under 40, people with diabetes seem to have a low-to-moderate absolute risk of cardiovascular disease," she says. "So at that age, it makes sense to individualize treatment."
Dr. Srinivas says efforts at prevention could well start even earlier, with educational programs for children on the risks of diabetes.
Always consult your physician for more information.
|
Overweight and obesity together represent the second leading preventable cause of death in the US.
Obesity is a serious, chronic disease that can inflict substantial harm to a person’s health.
Over weight and obesity are not the same; rather, they are different points on a continuum of weight ranging from being underweight to being morbidly obese.
The percentage of people who fit into these two categories, overweight and obese, is determined by Body Mass Index (BMI).
More than fifteen percent of children between the ages of six and 19 are overweight. Public health officials say physical inactivity and poor diet are catching up to tobacco as a significant threat to health.
Currently, about 33 percent of women and 28 percent of men are considered seriously overweight. Obesity is a serious, chronic disease that can inflict substantial harm to a person's health.
Obesity has a far-ranging negative effect on health. Each year obesity-related conditions cost over 100 billion dollars and cause an estimated 300,000 premature deaths in the US.
The health effects associated with obesity include, but are not limited to, the following:
high blood pressure
Additional fat tissue in the body needs oxygen and nutrients in order to live, which requires the blood vessels to circulate more blood to the fat tissue. This increases the workload of the heart because it must pump more blood through additional blood vessels. More circulating blood also means more pressure on the artery walls. Higher pressure on the artery walls increases the blood pressure. In addition, extra weight can raise the heart rate and reduce the body’s ability to transport blood through the vessels.
diabetes
Obesity is the major cause of type 2 diabetes. This type of diabetes begins in adulthood. Obesity can cause resistance to insulin, the hormone that regulates blood sugar. When obesity causes insulin resistance, the blood sugar becomes elevated. Even moderate obesity dramatically increases the risk of diabetes.
heart disease
Atherosclerosis (hardening of the arteries) is present 10 times more often in obese people compared to those who are not obese. Coronary artery disease is also more prevalent because fatty deposits build up in arteries that supply the heart. Narrowed arteries and reduced blood flow to the heart can cause chest pain (angina) or a heart attack. Blood clots can also form in narrowed arteries and cause a stroke.
metabolic syndrome
The National Cholesterol Education Program has identified metabolic syndrome as a complex risk factor for cardiovascular disease. Metabolic syndrome consists of six major components: abdominal obesity, elevated blood cholesterol, elevated blood pressure, insulin resistance with or without glucose intolerance, elevation of certain blood components that indicate inflammation, and elevation of certain clotting factors in the blood. In the US, approximately one-third of overweight or obese persons exhibit metabolic syndrome.
Always consult your physician for more information. |
