ADA:
Those with Higher CRP Values Greater Risk for Cardiovascular Disease
In
Kuwait, research found that “the percentage of diabetic individuals
who were in the highest 20% of CRP values were four times more likely
to be suffering from cardiovascular disease compared to those who were
in the lowest 20% of CRP,” according to Nabila Abdella, MB, CHP,
FRCP, Professor of Medicine at Kuwait University. Therefore she
concludes that a high CRP value is indicative of a high risk for
cardiovascular disease among those with diabetes and warrants more
aggressive management, including tight control of blood sugar, blood
pressure, and high cholesterol, as well as daily aspirin. In a Hong
Kong study, a high CRP level was found to be an independent predictor
for development of diabetic nephropathy.
ADA:
Drugs Now Available to Treat Inflammation of CVD
Two
classes of drugs statins and thiazolidinediones are available to treat
inflammation.
Although
some research is underway to explore the benefits of potent
anti-inflammatory drugs, other studies have shown that several drugs
already widely used by people with diabetes have anti-inflammatory
benefits. Rosiglitazone (Avandia) is one of a class of drugs (thiazolidinediones)
known to lower blood sugar and is widely prescribed for type 2
diabetes. In a recent study, standard doses were given to a group of
people with diabetes and blood samples were taken at baseline and at
1, 2, 4, 6, and 12 weeks. A series of markers of inflammation,
including CRP and NFkappaB, were measured.
“Not
only did average blood glucose levels fall from 147 to 127 as
expected, but all the indicators of inflammation fell by 20% to 40% by
week 6, when the drug was discontinued,” reports Paresh Dandona,
M.D., Ph.D., Head of the Division of Endocrinology, Diabetes, and
Metabolism at the State University of New Youk at Buffalo.. “This
leads us to speculate that patients treated with rosiglitazone might
not develop atherosclerosis at the high rate usually seen in
diabetes.”
In
addition, Dr. Dandona suggested that such anti-inflammatory treatment
of those at risk for diabetes might help prevent the disease itself. A
class of drugs used to reduce high cholesterol levels – the HMG-CoA
reductase inhibitors, nicknamed “statins,” – are also widely
used by people with diabetes and have also been found to reduce
inflammation. Now, a study has been made of Saskatchewan adults who
were newly started on any of the oral hypoglycemic agents used to
treat type 2 between the years of 1991 and 1996. Records were kept to
determine who was also given a statin, to discern whether such
treatment might increase the period of time to when these patients
were prescribed insulin for their diabetes, a signal of worsening
control. “We found that statin use was associated with an average
10-month delay before starting insulin treatment,” reported Jeffrey
A. Johnson, Ph.D., associate professor of Public Health Sciences at
the University of Alberta, Canada. His group recommended that the
potential of statins to delay onset of diabetes in high-risk
individuals be evaluated. American
Diabetes Association's 62nd Annual Scientific Sessions
FACT
PHYSICIANS
RANK DIABETES AS HIGHER RISK FACTOR FOR CARDIOVASCULAR DISEASE THAN
SMOKING, NEW SURVEY FINDS
