These diets could reduce CVD risk for adults with type 1 diabetes

From healio.com

• The Mediterranean and DASH diets emphasize plant-based foods, lean protein and healthy fat intake.
• The diets were associated with changes in blood markers of Cardiovascular Disease (CVD).

CHICAGO — For adults with type 1 diabetes, the Mediterranean and DASH diets could help reduce the risk for CVD, according to research presented at NUTRITION.

Both diets emphasize plant-based foods, lean proteins, healthy fats and low intake of sugars and processed foods, Arpita Basu, PhD, RD, an associate professor in the department of kinesiology and nutrition sciences at the University of Nevada at Las Vegas, and colleagues reported.

“Type 1 diabetes increases the risk of developing CVD, which raises the likelihood of heart attacks, strokes and other serious health complications,” Basu said in a press release. “We wanted to find out how people’s regular eating habits affected blood inflammatory markers that predict CVD risk in adults with type 1 diabetes.”

The researchers conducted a 6-year study including 1,255 adults — 692 without diabetes and 563 with type 1 diabetes. They used a food frequency questionnaire to calculate nutrient intake over the study period and assess how well the participants adhered to the Mediterranean diet, the DASH diet and the alternative healthy eating index (AHEI), which are commonly used in CVD management.

For adults with type 1 diabetes, the Mediterranean and DASH diets could help reduce the risk for CVD, according to research presented at NUTRITION. Image: Adobe Stock

They additionally analyzed blood markers that they said clinicians often use to determine inflammation and CVD risk: C-reactive protein, fibrinogen, homocysteine (Hcy) and plasminogen activator inhibitor-1 (PAI-1).

“Both DASH and Mediterranean diets revealed protective associations, which means these dietary patterns can make a difference when consumed regularly,” Basu said. “Our findings are more practical than those from clinical studies of these diets because those usually manipulate dietary behaviour in a way that may not be sustainable in daily life.”

The researchers found that adults with type 1 diabetes typically consume a high-fat diet, which they said was mostly a result of reducing carbohydrate intake and increasing animal protein foods that are high in cholesterol and saturated fats.

After adjustment for age, BMI, sex, physical activity, BP and more, those who adhered most closely to the Mediterranean and DASH diets had lower PAI-1 and Hcy levels, but the AHEI diet showed no connections.

“There is an urgent need to address dietary quality in adults with type 1 diabetes,” Basu said. “In a clinical setting, assessing dietary intakes using the DASH and Mediterranean dietary checklists could be an effective way to identify gaps and improve intakes. Specific foods that are part of these dietary patterns, such as olives and nuts in the Mediterranean diet, could be added to the diet even if the entire diet cannot be altered.”

https://www.healio.com/news/primary-care/20240630/these-diets-could-reduce-cvd-risk-for-adults-with-type-1-diabetes 

The Vegan Guide to Omega-3s

From vegnews.com

Find out how much omega-3s you need to thrive, the best plant-based sources, and why you should avoid fish as a source of the essential fatty acid

Whether it’s from an ad on television or your doctor, you’ve likely heard that omega-3 fatty acids provide many health benefits. According to the National Institutes of Health (NIH), these essential nutrients provide your body with energy, prevent vision loss, support brain health, improve cognitive function, and protect your heart by reducing your risk of cardiovascular disease. However, not getting enough (or too much) omega-3s can have consequences for your health. So, what’s a vegan to do when the most common dietary sources of omega-3s are fish and other seafood, and the vast majority of omega-3 supplements are derived from fish oil? Read on. It is possible to obtain enough omega-3 fatty acids on a vegan diet, but first, you need to understand how much you actually need. Here is how to optimize your omega-3 intake and live your best vegan life.

What are omega-3s?

Omega-3s are essential fatty acids, meaning you need to acquire them through food as your body cannot produce them on its own. Omega-3 fatty acids are vital components of the membranes surrounding every cell in your body. They’re also anti-inflammatory and help support communication between cells.

The three types of omega-3s are alpha-linolenic acid (ALA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA). ALA is the plant-based omega-3, most commonly found in walnuts, chia seeds, flax seeds, hemp seeds, Brussels sprouts, kidney beans, and other whole plant foods. DHA and EPA are found in marine foods such as algae, seaweed, fish, and other seafood.

Each of the omega-3 fatty acids is necessary for staying healthy, but DHA and EPA are of particular importance. A 2012 article published in Advances in Nutrition reports that DHA and EPA are critical for heart health, brain health, cognitive function, and foetal development. The marine omega-3s have also been found to help reduce heart disease risk, prevent macular degeneration (vision loss), and help treat Alzheimer’s disease. Interestingly, our bodies can convert ALA into DHA and EPA. However, this process is ineffective and the conversion rate varies based on the individual. Generally, our bodies cannot convert sufficient amounts of ALA into DHA and EPA; therefore, we need to seek out these two variations through food or supplements.

“Omega-3 fatty acids are essential fats that we must get from food because we don’t produce them in our bodies. Omega-3s are long-chain polyunsaturated fats (PUFAs) typically associated with fish/fish oils, but that’s because of marketing,” Dr. Dana Ellis Hunnes, PhD, MPH, RD, senior dietitian at the UCLA Medical Center and author of Recipe for Survival, tells VegNews.

“We can get all the omega-3s we need from plant-based sources,” says Dr. Dana Ellis. 

The problem with getting omega-3s from fish

Foods such as sardines, salmon, mackerel, and fish oil supplements have long been touted as the ideal sources of omega-3s. However, you may be surprised to learn this is not the case. DHA and EPA aren’t produced by fish but by algae. Fish are high in omega-3s because algae is a significant part of their diets. Algae are plant-based sources of DHA and EPA that are safe for everyone to consume, including vegans and vegetarians.

Besides the ethical and environmental implications of eating fish and using them to produce fish oil supplements, fish are high in mercury—a naturally occurring heavy metal that’s highly toxic and accumulates in the bodies of fish. When you eat fish high in mercury, that mercury can build up in your blood over time and negatively impact your health. In addition, many fish eat microplastics that have chemical residues in them. These microplastics can attach to fatty acids, such as omega-3s. Furthermore, current overfishing practices are a growing environmental and sustainability issue.

“There are a lot of toxins in our environment and many of them often end up in the ocean. For example, eight million metric tons of plastics end up in the ocean each year, and plankton eat them, bigger fish eat them, and so on,” Dr. Ellis Hunnes explains. “These plastics/chemicals get stored in fish fat. In addition, mercury is another toxin in the environment and in larger fish (tuna and sharks). So getting omega-3s from plant-based sources essentially eliminates this risk.”

How much omega-3 do you need?

So what can you do to get adequate amounts of DHA and EPA if you don’t consume fish or their oil? Cut out the middleman. Vegans can supplement their omega-3 intake with plant-based algae oil. Research shows that eating seaweed or taking an algae oil supplement boosts DHA levels more effectively than eating foods rich in ALA.

However, Dr. Ellis Hunnes says supplementing isn’t necessary—if you know what to eat.

“If people eat enough omega-3s from plant sources such as walnuts, chia seeds, flax seeds, and their oils, there’s no need to supplement omega-3. Moreover, a lot of literature suggests a whole food plant-based diet is far healthier and better for you than an unhealthy standard American diet supplemented with omega-3,” explains Dr. Dana Ellis.

Currently, the recommended daily intake (RDA) for ALA is 1.6 grams for men and 1.1 grams for women. As for DHA and EPA, there’s no official RDA. However, most experts and health organizations agree that 250 to 500 milligrams of combined DHA and EPA is adequate for most adults. According to the NIH, the symptoms of an omega-3 deficiency often appear on the skin as rough, scaly patches or a red, swollen, itchy rash. Conversely, if you overdo it and consume too much omega-3, you could experience some unwanted side effects, such as elevated blood sugar, increased risk of bleeding, low blood pressure, diarrhoea, acid reflux, stroke, and insomnia, according to the experts at Healthline.

The bottom line on omega-3s

At the end of the day, don’t stress over your omega-3 intake. Vegans, vegetarians, and omnivores can get enough omega-3 fatty acids through plant sources such as walnuts, brussels sprouts, seeds, seaweed, and algae. It’s a wise decision to take a plant-based algae oil supplement as an insurance policy to ensure you get enough DHA and EPA to protect your heart and brain health. Be cautious and speak with your healthcare provider before taking any new supplements.

https://vegnews.com/2022/9/vegan-guide-omega-3-products

 

Diabetes Side Effects and Comorbidities

From verywellhealth.com

When an individual has diabetes, it requires a lifestyle change. If changes aren’t made, diabetes can lead to other health conditions.

As a person with diabetes, it is important to fully follow the plan that is given by your doctor to help your condition and possibly prevent long-term complications.

This article outlines comorbidities that can occur alongside diabetes.

Sanjeri / Getty Images

Cardiovascular Disease

Research shows it is common that people with diabetes also have cardiovascular disease and other heart-related issues. These conditions are intertwined and can create complications.

It is possible for people who have longstanding diabetes and heart-related conditions to develop other complications such as: 

• Stroke
• Congestive heart failure
• Coronary artery disease
• Peripheral vascular disease

When a person has type 2 diabetes, their risk for cardiovascular mortality and morbidity is higher than those who do not have diabetes. This is due to the lack of glycaemic control.

Other risk factors include:

• Obesity
• Smoking
• Lack of physical activity

All of these are factors of both conditions.

Research shows that when a person has type 1 diabetes, cardiovascular disease is a major cause of mortality. It is important to work with your healthcare professional to understand your conditions and follow the specified treatment plan related to both.

Dry Mouth

Diabetes can cause too much glucose in the blood. As a result, this can cause infection, pain, and dryness in the mouth.

High amounts of glucose will reduce the ability of saliva to produce effectively. When there are high glucose levels in the saliva, this increases the growth of bacteria. This can also increase the risk of:

• Gum disease
• Plaque
• Tooth decay

Some of the symptoms along with dry mouth include:

• Pain
• Cracked lips
• Mouth infection
• Problems eating
• Problems swallowing
• Problems talking

Along with taking your medicine prescribed by your doctor, other treatments that can help include:

          Consuming frequent sips of water

• Rinsing the mouth with fluoride to prevent cavities
• Avoiding caffeine, tobacco, and alcohol
• Consuming sugarless gum or mints to increase the flow of saliva
• Avoiding foods with high amounts of sodium and foods that are spicy
• Using a humidifier at night
• Having a good oral hygiene regimen

It is important to develop a treatment plan with your healthcare professionals. Both your doctor and dentist can help with a plan that is effective.

Erectile Dysfunction

Research has shown that erectile dysfunction is known to be a complication of diabetes. It is also an under-reported and under-diagnosed condition. Therefore, treatment and the age of diagnosis are delayed.

People who are older and have poor glycaemic control are known to have a higher risk of getting severe erectile dysfunction.

Fatigue

Fatigue is known as mental or physical exhaustion. It can be triggered by:

• Overwork
• Physical illness
• Medication
• Stress
• Disease
• Mental illness

When a person is fatigued, it can impair the mental and physical function for both short-term and long-term activities. Studies recommend that if an individual presents with complaints of fatigue, a healthcare professional should conduct a focused medical and endocrine check-up.

Fatigue is a common factor for both type 1 and type 2 diabetes. Along with diabetes medication, there are other risk factors of fatigue, including: 

• Inflammation
• High body mass index
• Depression
• Poor diet
• Lack of exercise and physical activity
• Poor sleep habits

Some people with diabetes become depressed, which is another condition that is, at times, diagnosed as fatigue.

It is important to speak with a healthcare professional about your specific symptoms so they can accurately diagnose the condition. If the lifestyle, nutritional, and medical factors are ruled out, a targeted gluco-endocrine evaluation should be done to determine a diabetes fatigue syndrome diagnosis.

Foot Ulcers

Diabetic foot ulcers occur in approximately 15% of people with diabetes. The length of time a person has had diabetes is a factor as to whether or not a patient will get a foot ulcer. 

The condition can show up as:

• Numbness in the foot
• Poor circulation
• Foot deformities

About 6% of people with diabetes could be hospitalized due to complications or infections of a foot ulcer.

If a person has type 1 or type 2 diabetes, they can get a foot ulcer. Certain individuals are at higher risk, including those who:

• Have peripheral vascular disease
• Have neuropathy
• Have poor glycaemic control
• Smoke cigarettes
• Have diabetic nephropathy
• Have had previous foot ulcerations/amputations
• Use insulin
• Are overweight
• Consume alcohol

People who have diabetes-related eye disease, heart disease, and kidney disease are also at a higher risk. 

Treatment for diabetic foot ulcers includes:

• Applying medication or dressings to the ulcer
• Managing blood glucose
• Taking the pressure off the area
• Removing dead skin and tissue

Ulcers are not always infected. If one does become infected, see your healthcare professional regarding proper medication and care.

Gum Disease

Gingivitis or gum disease occurs when plaque builds up around your teeth and inflammation in the gums occurs. For people who have diabetes, the inflammatory response to the plaque is greater.

Some of the symptoms of gum disease include:

• Loose teeth
• Sensitive teeth
• Gums that are swollen, red, or bleeding
• Bad breath

If a person does have gum disease and it goes untreated, it can turn into periodontitis. This is an infection that damages the soft tissue of the gum, and it can damage the bones that support your teeth.

Some of these suggestions can help prevent gum disease: 

• Avoid acidic drinks—they are known to erode the enamel on the teeth
• Floss regularly
• Regularly brush your teeth and gum line gently
• Brush your tongue to help get rid of bacteria

It is important to go to your regularly scheduled dental and doctor appointments. Your healthcare professionals can help you create a plan and possibly prevent complications.

Hearing Loss

A large number of people have both hearing loss and diabetes. It is estimated that 34.5 million people have hearing loss and more than 34 million people in the United States have diabetes. 

A recent study reported that hearing loss is twice as common with people who have diabetes. It is speculated that high blood glucose levels in diabetic patients may cause damage to the small blood vessels in the inner ear. However, more research needs to be conducted to confirm this theory. 

Although hearing loss is gradual over time, it is important to look for symptoms. Some of the signs of hearing loss are the following: 

• Turning up the television to a volume that is too loud
• Asking people to repeat themselves
• Trouble following conversations that have more than two people

If you feel you are experiencing hearing loss, contact your doctor so they can assist you in getting the help that you need.

Hypoglycaemia

Hypoglycaemia happens when the blood sugar falls below a certain range. If the blood sugar falls below 70 mg/dL, that is considered too low. It is important to check with your healthcare professional about your specific numbers.

If you are diabetic and hypoglycaemic, this may cause an insulin shock.

Some ways to stay current with your blood sugar numbers is to:

• Regularly check your blood sugar
• Use a monitor
• Keep an eye out for symptoms

Hypoglycaemia symptoms include:

• Being nervous or anxious
• Sweating or chills
• Irritability or impatience
• Confusion
• Tiredness
• Feeling weak or having no energy
• Blurred/impaired vision
• Tingling or numbness in the lips, tongue, or cheeks
• Headaches
• Clumsiness
• Nightmares or crying out during sleep
• Seizures

If you have any of these symptoms, contact your doctor right away.

Kidney Failure

The kidneys are an important function of the body. Diabetes is the leading cause of kidney disease. In fact, about one out of three adults with diabetes have kidney disease.

A healthy kidney filters waste out of the bloodstream and controls blood pressure. If a kidney is not healthy, it can’t filter properly and the waste will build up.

An unhealthy kidney can also lead to other health problems. If a person has diabetes over a period of years, the kidney will become damaged, disease can occur, and eventually kidney failure can occur. This is due to the blood pressure and glucose being too high.

It is important to talk to your doctor and check your kidneys to make sure they are healthy. It is recommended that you get tested every year if you have type 2 diabetes and if you’ve had type 1 diabetes for more than five years.

If a person has diabetes and is not active, eats foods high in sodium, doesn’t follow the eating plan, smokes, has heart disease, or is obese, they are at an increased risk of developing kidney disease and/or failure.

Memory Loss

When a person has diabetes, it may increase the risk of memory loss and other cognitive problems.

When the blood glucose is higher than normal, it is known to damage nerve cells and blood vessels in the body and brain. Diabetes is also known to damage the capillaries which could also cause a slow progression of memory loss.

Research has shown that people with type 2 diabetes could have a higher risk of developing dementia. Overall, if the diabetes is not properly controlled, the chances of having complications with memory are higher. It is important to manage your condition and follow the plan provided by your doctor.

Neuropathy

Diabetic neuropathy happens when there is nerve damage due to diabetes. There are different types with different symptoms. Some of the symptoms affect the internal organs, heart, and bladder.

A person who has this condition may experience pain and numbness in the feet and issues with internal organs.

With diabetic neuropathy, nerve damage happens over time. This is due to the high blood sugar, and high levels of triglycerides in the blood due to diabetes. There are different types of diabetic neuropathy, and the symptoms for each vary. These include: 

• Peripheral neuropathy: This is very common and is known to affect primarily the feet and legs. There are times that the arms and hands are affected too. Approximately one-half to one-third of patients with diabetes have peripheral neuropathy.
• Autonomic neuropathy: This affects the nerves that control the internal organs. It is also known to lead to hypoglycemic unawareness. This can create complications with the digestive system, bladder, sweat glands, eyes, heart rate, and blood pressure.
• Focal neuropathies: This causes damage to single nerves that are common in the head, leg, torso, or hand. Carpal tunnel syndrome is the most common type of this condition.
• Proximal neuropathy: This typically affects one side of the body. The areas that are impacted are the buttock, thigh, and hip. The symptoms are known to improve over a period of months or years.

Obstructive Sleep Apnoea

Obstructive sleep apnoea commonly affects people who have type 2 diabetes. Research shows that up to 83% of people with type 2 diabetes have this condition.13

There is an association between this condition, insulin resistance, and glucose intolerance. More research needs to be done to conclude that treatment of obstructive sleep apnoea can prevent the compilations and development of type 2 diabetes.

Skin Infections

Diabetes affects the skin in different ways. Sometimes, certain problems with the skin such as itching, fungal infections, and bacterial infections are a sign that a person has the condition. If an individual has diabetes, they are known to get these types of skin conditions easier.

Other skin conditions that people specifically with diabetes could develop include: 

• Acanthosis nigricans: This appears on the side of the armpits, neck, and groin as tan or brown raised areas. They can occasionally appear on the hands, knees, and elbows.
• Diabetic dermopathy: These are patches that are circular or oval. The texture and colour are scaly and light brown. They primarily appear on the front of the legs. The patches are not known to hurt or itch.
• Necrobiosis lipoidica diabeticorum: This is a rare condition that is commonly known to affect adult women. Necrobiosis lipoidica diabeticorum begins as a raised area that is red and dull. Over time it develops into a shiny scar with a violet border. This skin condition is known to be painful and itchy, and the spots may crack open. If this happens, contact your doctor to get treatment.

Vision Impairment

When an individual has diabetes, they can develop problems with their eyes. Diabetic retinopathy can cause complete blindness and vision loss in people with diabetes.

This condition affects the blood vessels in the retina. Diabetic retinopathy can lead to:

• Neovascular glaucoma: This happens when fluid is blocked from draining out of the eye due to abnormal blood vessels growing out of the retina.
• Diabetic macular edema: When this condition occurs, the vision becomes blurry because there is extra fluid in the macula. The extra fluid is due to the blood vessels in the retina that leak fluid and cause swelling in the macula area of the eye.

Although there are no direct symptoms, it is important to notice any changes in the eyes. As a person with diabetes, it is important to get an eye exam once a year, including a comprehensive dilated exam. This can help with prevention and vision protection.

A Word From Verywell

If you are an individual who is living with diabetes, it is important to follow the plan that your doctor has created for you. It is also important to educate yourself on your condition so you can have a healthy quality of life and prevent any complications. If you have questions or concerns about your condition, your doctor can help.

https://www.verywellhealth.com/side-effects-of-diabetes-5181506

Good News for Those with Type 2 Diabetes: Healthy Lifestyle Matters

From chicagohealthonline.com

Type 2 diabetes is a metabolic disorder of insulin resistance — a reduced sensitivity to the action of insulin — which leads to high blood sugar, or hyperglycaemia. Approximately 12% of American adults have type 2 diabetes, and more than one-third of Americans have prediabetes, a precursor to type 2 diabetes. This is a major public health concern, as type 2 diabetes dramatically increases risk for heart disease, including heart attacks, atrial fibrillation, and heart failure.

The development and progression of type 2 diabetes is affected by many factors. Some, such as a person’s race/ethnicity, age, and gender cannot be modified. Others, including body weight, exercise, and diet can be changed.

Can lifestyle changes help reduce heart disease risk if you have diabetes?

In 2010, the American Heart Association (AHA) published “Life’s Simple 7,” which it defined as “seven risk factors that people can improve through lifestyle changes to help achieve ideal cardiovascular health.” The Simple 7 touched on smoking status, physical activity, ideal body weight, intake of fresh fruits and vegetables, blood sugar, cholesterol levels, and blood pressure.

Subsequent studies found that people in optimal ranges for each of these factors had lower risks of heart disease compared to people in poor ranges. But given the significant increase in heart disease risk in those with type 2 diabetes, it was not clear if the impact of these modifiable factors would hold true for the type 2 diabetes population.

Recent study suggests lifestyle changes do benefit type 2 diabetes and prediabetes

A study published in JAMA Cardiology looked at whether the ideal cardiovascular metrics covered in Life’s Simple 7 translate into improved cardiovascular health for those with type 2 diabetes or prediabetes. The results were exciting and consistent with other large population-based studies. Patients who had five or more ideal cardiovascular measures had no excess of cardiovascular events compared with people with normal blood sugar levels. Cardiovascular events measured in the study included death, heart attack, stroke, and heart failure. Each additional ideal health metric was associated with an additional 18% drop in cardiovascular event risk for people with type 2 diabetes and an additional 15% drop for those with prediabetes.

This was a prospective, observational study, examining the association of risk factors only. It was not a randomized trial looking at an intervention. As a result, we cannot draw conclusions about cause and effect. Nonetheless, this is the first study to show a positive association between ideal lifestyle factors and cardiovascular health in people who are at high risk for cardiovascular disease due to type 2 diabetes. These results showcase the importance of our lifestyle choices, suggesting that meeting ideal health metrics can help reduce risk of cardiovascular events.

Life’s Simple 7

So what are the lifestyle and metabolic health goals should you strive for, whether or not you have diabetes?

1. Manage blood pressure. 120/80 mm Hg or lower is best.
2. Control cholesterol. Aim for total cholesterol below 200 mg/dL.
3. Reduce blood sugar. Get your HbA1c (an average measure of blood sugar over the past three months) under 5.7% if you have prediabetes, or below 6.5% if you have type 2 diabetes.
4. Get active. Your goal is 150 minutes per week of moderate-intensity activity or 75 minutes per week of vigorous activity.
5. Eat better. That means at least 4.5 cups of fruits and vegetables per day.
6. Lose weight. You want a body mass index (BMI) of less than 25.
7. Stop smoking. You’ll reap cardiovascular benefits, not to mention lowering your risk for cancer, COPD, and much more.

(Alyson Kelley-Hedgepeth, MD, is a contributor to Harvard Health Publications.)

https://chicagohealthonline.com/good-news-for-those-with-type-2-diabetes-healthy-lifestyle-matters/

Risk of heart attacks halves in patients with Type 2 diabetes in 15 years

From escardio.org

Sophia Antipolis, France – 29 Aug 2020:  Dramatic reductions in the risk of heart attacks in patients with diabetes coincides with major increases in the use of preventive medications. That’s the finding of late breaking research presented today at ESC Congress 2020.

“Our results suggest that when patients are diagnosed with type 2 diabetes, starting medications to prevent cardiovascular disease has a substantial impact on the risk of heart attacks and premature death,” said principal investigator Dr. Christine Gyldenkerne of Aarhus University Hospital, Denmark.

People with type 2 diabetes are twice as likely to have a heart attack or die from heart disease compared to people without diabetes.

Management of patients with type 2 diabetes has changed considerably over the last two decades, with increased focus on prevention of cardiovascular disease. This was the first study to examine how these changes may have affected the risk of heart attacks and premature death in patients with newly diagnosed type 2 diabetes and no previous cardiovascular disease.

The researchers identified all patients in Denmark initiating therapy for type 2 diabetes from 1996 to 2011 – a total of 211,278 patients. Each patient with diabetes was matched on age and sex with five people without diabetes from the general population. Those with previous cardiovascular disease were excluded.

All participants were followed for seven years. Using data from national health registries, the researchers recorded heart attacks and death during follow-up. They also noted the use of medications to prevent cardiovascular disease at the time of diabetes diagnosis.

The researchers found that patients with newly diagnosed type 2 diabetes and no previous cardiovascular disease experienced major reductions in the risk of heart attack and death. From 1996 to 2011, the relative risk was reduced by 61% for heart attack and by 41% for death. During the same period, the absolute risks of heart attack and death reduced by 4% and 12%, respectively.

When comparing patients with diabetes to the general population, the initially large differences in risk narrowed over time. By the end of the study, the risk of heart attack among patients with diabetes was only marginally – 0.6% – higher than in the general population.

In those with diabetes, use of cholesterol-lowering medications increased more than 10-fold, aspirin increased by 50%, and blood pressure-lowering medications increased up to four times during the study period.

Dr. Gyldenkerne said: “The risk of heart attack and premature death among patients with newly diagnosed type 2 diabetes and no previous cardiovascular disease was approximately halved from 1996 to 2011. In the same period, the difference in risk of heart attack and death for patients with diabetes, as compared to the general population, was narrowed substantially.”

She noted that this was an observational study and causation cannot be assumed. Dr. Gyldenkerne said: “In addition to the use of preventive medications, other factors may have influenced the likelihood of heart attack and premature death. For example, stricter control of diabetes and lifestyle changes such as smoking cessation, physical activity, and healthier food may have contributed to the improved prognosis.”

https://www.escardio.org/The-ESC/Press-Office/Press-releases/Risk-of-heart-attacks-halves-in-patients-with-diabetes-in-15-years