Diabetes Q&A

Prediabetes Is a “Red Flag” for Future CVD Risk

A midlife diagnosis of prediabetes should be taken as a warning of future risk of diabetes and cardiovascular disease (CVD), according to the results of a recent study.

 

In order to estimate the long-term risk of CVD based on fasting glucose (FG) levels that are below the threshold of diabetes, the researchers conducted a study using data from 19,630 participants from 7 observational cohorts of US adults followed from 1960 to 2015. FG levels were categorized as <5.0, 5.0–5.5, 5.6–6.2, 6.3–6.9 mmol/L, and diabetes (FG ≥7.0 mmol/L or use of diabetes medications). CVD was defined as coronary heart disease and stroke.

Read More...

Clinical Pearls: Diabetes and Hypertension Guidelines

Clinical Inertia in Diabetes: How Did We Get Here?

Using a modified Kaplan-Meier survival analysis, the researchers estimated risk of CVD by FG category at age 55 years. They also assessed risk for CVD based on change in FG before age 50 years in individuals in the <5.6 mmol/L, 5.6–6.9 mmol/L, and diabetes categories.

 

Overall, risk of CVD through age 85 years ranged from 15.3% in the <5.0 mmol/L group to 38.6% in the diabetes group among women and 21.5% in the 5.0–5.5 mmol/L group to 47.7% in the diabetes group among men.

 

Further, an FG of 6.3-6.9 mmol/L was associated with a higher long-term risk of CVD compared with the lowest FG among men, but not in women. Conversion to diabetes in midlife was associated with higher CVD risk (1.3- to 3.6-fold) than was increases in FG below the diabetes threshold.

 

“Our study provides further evidence that if you can avoid diabetes you may be able to stave off cardiovascular disease. Pre-diabetes should serve as a red flag to doctors to closely monitor their patient’s blood sugar to try to prevent diabetes through lifestyle interventions like better diet and increased physical activity, and if necessary, with pharmacologic therapies.”

—Michael Potts

 

Reference:

  1. Bancks MP, Ning H, Allen NB, et al. Long-term absolute risk for cardiovascular disease stratified by fasting glucose level [published online January 7, 2019]. Diabetes Care. https://doi.org/10.2337/dc18-1773.
  2. Early detection of prediabetes can reduce risk of developing cardiovascular disease [press release]. January 22, 2019. https://newsroom.wakehealth.edu/News-Releases/2019/01/Early-Detection-of-Prediabetes-Can-Reduce-Risk--of-Developing-Cardiovascular-Disease.