A recent study published in The New England Journal of Medicine found five target areas for people with type 2 diabetes in order to decrease their chance of death, myocardial infarction, or stroke: elevated glycated hemoglobin level, elevated low-density lipoprotein cholesterol level, albuminuria, smoking, and elevated blood pressure.
The cohort study included 271,174 type 2 diabetes patients and 1,355,870 age-, sex-, and county-matched controls. Researchers followed up after a mean of 5.7 years. For diabetic patients whose risk factors were in the target ranges, when compared with the controls, the hazard ratios (HR) were 1.06 for death by any cause, 0.84 for acute myocardial infection, and 0.95 for stroke. HR for hospitalization for heart failure among the diabetic group was 1.45. For the type 2 diabetes patients, smoking was the strongest predictor of death, and an elevated glycated hemoglobin level was the greatest predictor of stroke and acute myocardial infarction.
Original Article: Risk Factors, Mortality, and Cardiovascular Outcomes in Patients with Type 2 Diabetes https://t.co/gURQcykvvg pic.twitter.com/sJx4tOAtqE
— NEJM (@NEJM) August 29, 2018
“The study indicates that having all five risk-factor variables within the target ranges could theoretically eliminate the excess risk of acute myocardial infarction,” the study authors wrote.
What makes the study unique compared to previous clinical trials is that it focuses on targeting multiple risk factors at once, lead author Dr. Aidin Rawshani told TCTMD.
“There are only a few clinical trials that have studied the importance of treating several risk factors at once, compared to usual care for these risk factors,” he said.
#Diabetes doesn’t always show obvious symptoms, so it’s good to know the risk factors. Find out if you’re at risk: https://t.co/IW5gw92PRp pic.twitter.com/WdgMlrzyHw
— CDC Diabetes (@CDCDiabetes) August 26, 2018
In an accompanying editorial, Dr. Steven Schroeder noted that targeting risk factors may be more difficult for members of certain vulnerable populations.
“A cautionary note is that pathways to target levels of risk factor variables are not always straightforward and often involve issues of lifestyle, adherence to medication, and other behaviors that are hard to modify, despite best attempts,” Schroeder wrote. “For vulnerable populations, risk factor control may be especially challenging, as shown by the widening health gap between social classes.”
Many people are unaware of the risk factors and symptoms of type 2 diabetes. Learn more about your risk and what action you can take to reduce it.https://t.co/9NtblgZsRH pic.twitter.com/0nheqLs3gS
— Int. Diabetes Fed. (@IntDiabetesFed) August 23, 2018
Sources: New England Journal of Medicine, TCTMD
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