Symptomless Heart Disease Common Among Diabetics

More than one fifth of patients with type 2 diabetes have decreased blood flow to the heart, but no symptoms to suggest there is a problem. Known as myocardial ischemia, this serious condition occurs when the heart does not receive enough blood to meet its metabolic needs, usually due to plaque build-up in the coronary arteries. When no symptoms are present, the disease is said to be "silent."

Dr. Frans J. Th. Wackers from Yale University School of Medicine, New Haven, Connecticut stated that, "The patients recruited for the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study were selected in such a way that there was not even the slightest suggestion" of the presence of heart disease. "Yet we found that even in these patients with no symptoms, 22 percent" had myocardial ischemia.

In the DIAD study, Wackers and colleagues analyzed data from 522 patients with type 2 diabetes.

Of the patients with silent myocardia ischemia, only 60 percent met American Diabetes Association guidelines for heart disease screening, the investigators report.

"I suspect that in the real world, the (rate) of silent ischemia is even higher," Wackers said. "Our study shows again that diabetes is a very serious risk factor for" heart disease.

Wackers added that the American Diabetes Association should revisit their guidelines for heart disease screening in type 2 diabetics. "They obviously miss almost half the patients with silent" disease, he said. Diabetes Care, August 2004.