Recent Study Confirms Link Between Heart Disease and Type 2 Diabetes
October 31, 2002
By Audrey Walton, Heart1 Staff
The link between heart disease and type 2 diabetes is both well-documented and fatal, yet many people--particularly people in high-risk categories for both diseases--remain unaware of this connection, a recent study showed. In fact, cardiovascular disease causes two out of three diabetes-related deaths, making it the most fatal of all type 2 diabetes complications. The National Cholesterol Education Program classifies diabetics as no less at risk for CVD than those who have already had the disease. Diabetics are two to four times more likely than non-diabetics to suffer from heart disease or stroke. Diabetic patients who suffer from mild heart attacks are also almost twice as likely to die within 30 days as non-diabetic patients.
Type 2 diabetes, which accounts for 95% of all cases of diabetes, is the disease most affected by excess weight. Type 2 diabetes differs from type 1 diabetes in that a person with type 1 diabetes will produce no insulin, since the beta cells in the pancreas responsible for the production of insulin have been destroyed by the immune system. In type 2 diabetes, the body exhibits a syndrome known as insulin resistance: the pancreas initially produces adequate levels of insulin, but the body’s tissues fail to respond to the insulin properly. The pancreas goes into overdrive, producing excessive amounts of insulin in order to compensate for the body tissue’s unresponsiveness. After time, perhaps as a result of exhaustion, the pancreas stops producing abnormally high levels of insulin, and the level of sugar in the blood remains excessive. Research has shown that insulin resistance can lead to the increased risk of heart disease even in the absence of type 2 diabetes, which suggests that insulin resistance may be an independent risk factor for both type 2 diabetes and heart disease. Researchers propose that excess blood sugar may contribute to inflammation in the arteries, which can in turn promote atherosclerosis.
In addition, type 2 diabetes can heighten the incidence of several other risks for cardiovascular disease, including high blood pressure, blood clotting abnormalities, and abnormal lipids. About 40% of middle-aged diabetics and 60% of diabetics over 75 have high blood pressure. People with diabetes are also at a higher risk for blood clots, which can lead to both heart attacks and stroke, because they have abnormally sticky blood platelets and lack the proteins which break down blood clots. Lastly, diabetics often suffer from high levels of triglycerides and low-density lipoprotein, known as LDL or “bad “ cholesterol, and low levels of high-density lipoprotein, also known as HDL or “good” cholesterol, both of which can cause atherosclerosis.
Type 2 diabetes, and its complications, are becoming more prevalent. Type 2 diabetes was once called “adult onset” diabetes, because it occurred primarily among people over 40. In the 1990s, type 2 diabetes began to appear more and more among the younger population, particularly among African-Americans, Hispanics, and Native Americans. A recent study demonstrated that African-American women were more than 2.5 times more likely to develop diabetes than white women, and African-American men were 1.6 times more likely to develop diabetes than white men. The growing rates of diabetes among minority populations are the subject of ongoing research. “In a recent survey conducted by our organization, we found that nearly one out of two African-Americans and Hispanics with type 2 diabetes does not consider heart disease and diabetes to be related conditions,” said Malcolm P. Taylor, M.D., speaking on behalf of Take Diabetes to Heart, a national campaign which educates people about the link between Type 2 diabetes and heart disease. (The Take Diabetes to Heart homepage, which features a risk profiler and specific information on high risk groups, can be found at http://www.takediabetestoheart.com/take.htm.)
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH) are currently funding a new study on the long-term effects of weight loss in people with type 2 diabetes. This new study, which will take place at several medical centers in the Boston area, is the largest ever funded by the NIH on the effects of weight loss intervention. It will examine the effects of a “lifestyle intervention program,” consisting of reduced calorie intake and regular exercise, on people with type 2 diabetes, focusing on the rates of heart attack, stroke, and causes of death related to cardiovascular disease. Approximately 5,000 volunteers will participate in this study, of whom 33% are expected to come from ethnic minority groups. More information about the study can be found at http://www.LookAHEADstudy.org.
Last updated: 31-Oct-02
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