cardiovascular risk was twice as high up to 30 years before diagnosis

Type 2 diabetic patients are twice as likely to have suffered a myocardial infarction or ischemic stroke in the 30 years preceding diagnosis, shows a study by Danish registry published in the Journal of the American College of Cardiology (JACC).

“Many people have cardiovascular disease at the time of diagnosis of type 2 diabetes, raising the question of how long before clinical diagnosis the prevalence of cardiovascular disease was high. present Christine Gyldenkerne from the Department of Cardiology at Aarhus University Hospital in Denmark and her colleagues.

In this case-control and cohort study, carried out using data from the Danish National Health Registry, 127,092 people diagnosed with type 2 diabetes between 2010 and 2015 were matched by age and sex to 381,023 people from the general population. In the period up to 30 years before diagnosis of type 2 diabetes, 11.2% of people who developed diabetes and 4.7% of matched people had a myocardial infarction or ischemic stroke.

Throughout this period, the prevalence of cardiovascular disease was higher among people who developed diabetes than among matched controls, with a odds ratio (measure approximating that of relative risk) ranging from 2.18 for the period 25-30 years before diagnosis to 2.96 for the period of less than five years before diagnosis. “This result was observed as early as 30 years before the diagnosis of type 2 diabetes, much longer than previously documented,” specify the authors.

Regarding the five-year period following diagnosis, 4.6% of people with type 2 diabetes and 2.5% of individuals had a cardiovascular event, with a relative risk of 2.20. “This study highlights the importance of early detection and proactive management of people at high risk of cardiovascular disease and type 2 diabetes,” believe the authors. “Lifestyle interventions (e.g. following a healthy diet, preventing overweight/obesity or weight loss, engaging in physical activity while limiting time spent sitting ) constitute the cornerstone of primary prevention of type 2 diabetes and cardiovascular disease.”

While the risk of cardiovascular disease is high among patients with diabetes, this study suggests that at least part of this risk is more attributable to cardiovascular disease risk factors that are associated with diabetes than to diabetes itself, note -they.

(JACC, online publication of November 25)