Delayed Diabetes Diagnosis Reduces CVD Risk

According to a study presented at the American Diabetes Association’s 79th Scientific Sessions in San Francisco, patients with impaired glucose tolerance (IGT) could decrease their risk of cardiovascular disease (CVD) and microvascular disease if they delay their progression to type 2 diabetes (T2D).

IGT is a significant risk factor for developing T2D as well as CVD and microvascular disease. By improving glucose levels enough to prolong a T2D diagnosis—or returning glucose levels to normal—patients may have a much smaller risk of other complications.

The researchers for the present study evaluated data from the Da Qing Diabetes Prevention Study (DQDPS). In the DQDPS, researchers found that over a 20-year period, 90 percent of patients with IGT who received no intervention went on to develop diabetes. Additional risks associated with the diabetes diagnosis were not clear, though—which is what the authors of the current study, “Early Progression to Diabetes or Regression to Normal Glucose Tolerance Among People with Impaired Glucose Tolerance Affects Long-Term Outcomes: Thirty-Year Follow-Up of Da Qing Diabetes Prevention Study,” sought to determine.

The DQDPS included 540 Chinese adults with IGT. Patients were randomized to an intervention of diet, exercise, or both for six years. At the end of the study, 252 patients developed diabetes, of whom 65.6% developed CVD and 44.3% developed microvascular disease. Of the patients who still presented IGT (n = 114), 50.6% and 31.2% developed CVD and microvascular disease, respectively, and in the normal glucose group (n =  174), 46.1% and 23.1% developed CVD and microvascular disease, respectively. The study authors concluded that progression from IGT to diabetes was associated with a 69% higher CVD incidence and 150% higher microvascular incidence.

“We know people with impaired glucose tolerance are at high risk for developing diabetes and other complications,” said study author Guangwei Li, MD, honorary director of the International Medical Center at the China-Japan Friendship Hospital; and director of the center of endocrinology and cardiovascular disease at the National Center of Cardiology at Fuwai Hospital, Chinese Academy of Medical Sciences, in a press release. “Our study clearly shows that reversing or delaying the onset of diabetes in people with IGT by six years or more significantly lowers their risk for developing long-term complications such as CVD and microvascular disease. Essentially, the longer progression to diabetes can be delayed, the fewer the complications.”