Diabetes, Glucose Level, and Risk of Sudden Cardiac Death

Shows how important glucose levels are at every stage of diabetes progression

The prevalence of diabetes mellitus in industrialized countries is rapidly increasing, and diabetes is suspected to carry a particular high risk for sudden cardiac death (SCD).

We conducted a population-based case-control study at Group Health Cooperative. Cases (n = 2040) experienced out-of-hospital cardiac arrest due to heart disease between 1980 and 1994. Controls (n = 3800) were a stratified random sample of enrollees. Diabetes status was classified into four exclusive groups: (i) no diabetes, (ii) borderline, (iii) diabetes without microvascular disease (retinopathy or proteinuria), and (iv) diabetes with microvascular disease.

When compared with no diabetes, we observed progressively higher risk of SCD associated with borderline diabetes [Odds ratio (OR) = 1.24 (0.98-1.57)], diabetes without microvascular disease [OR = 1.73 (1.28-2.34)], and diabetes with microvascular disease [OR = 2.66 (1.84-3.85)], after adjustment for potential confounders (P-value for trend <0.001). Higher glucose levels were also associated with the risk of SCD both in the absence and in the presence of microvascular disease. However, subjects with microvascular complications but with glucose level <7.7 mmol/L were not at significant increased risk of SCD.

These results emphasize the role of diabetes as a strong risk factor for SCD and outline the importance of glucose level at every stage of diabetes severity.

Eur Heart J. Jun 24, 2005
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FACT:
Fit More Important than Fat: It’s an ongoing debate as to whether you can be both fit and fat. Being inactive is definitely a risk factor, no matter what your weight. Being physically active is protective, no matter what your weight. But being fat itself still entails risks. A study found the likelihood of having diabetes and diabetes-related cardiovascular disease increased with body mass index (BMI) regardless of physical activity. Diabetes and cardiovascular disease increased with physical inactivity regardless of BMI.
Moral: be active, no matter what your weight, at least 30 minutes a day, at least 3 days a week. If you are overweight, increase physical activity and begin to eliminate empty calories and non-nutritious foods from your plate.
Diabetes Care July, 2005

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