Issue 180 Item 9 Subclinical Atherosclerosis Precedes Clinical Onset of Diabetes

Results from a new study suggest that atherosclerosis levels are increased in patients who are later diagnosed with type 2 diabetes Numerous reports have linked diabetes with an increased risk of heart disease. However, it was unclear if increased atherosclerosis preceded or followed the clinical onset of diabetes. Although a recent report suggested that the elevated heart disease risk precedes the diabetes diagnosis, there has been no direct evidence of increased atherosclerosis prior to clinical onset. To investigate, Dr. Kelly J. Hunt, from the University of Texas at San Antonio, and colleagues used ultrasound to evaluate carotid artery intima-media thickness (IMT) in 1496 subjects. As part of the Mexico City Diabetes Study, all of the subjects were evaluated with ultrasound. At testing, 303 subjects had diabetes. Sixty-six would later develop diabetes, and 1127 would remain diabetes-free. The authors found that prediabetics and diabetics had common and internal carotid artery IMTs that were significantly higher than those of nondiabetics. However, after adjusting for known cardiovascular risk factors, only internal carotid artery IMT remained significantly elevated in the prediabetes group. In the diabetes group, both IMTs were still increased after adjusting for known risk factors. The new findings provide direct evidence that increased atherosclerosis precedes the clinical onset of diabetes, the investigators note: “If…the association between diabetes and coronary heart disease stems mainly from common antecedents, one way to prevent the development of atherosclerosis would be to identify and intervene in those at high risk of developing diabetes.” Arterioscler Thromb Vasc Biol 2003;23:1845-1850. ========================================== Breakthrough in Diabetes Education for Children dbaza inc. has created a product can help you use your education time more effectively, allowing you to spend your time on the more difficult issues. More Information