Early diabetes interventions may also reduce heart disease risk
Two treatments that slow the development of diabetes also may protect people from heart disease, according to a recent study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).
Researchers examined the effect that making intensive lifestyle changes or taking the medication metformin had on cholesterol and triglyceride levels. The study, part of the National Institutes of Health’s Diabetes Prevention Program, found that both treatments induced positive changes in the level of particles that carry cholesterol and triglycerides through the blood stream. These changes could lower the chances of plaque building up in blood vessels.
“Cardiovascular disease is the most significant cause of death and disability in people with diabetes,” said the study’s lead author, Ronald Goldberg, MD, of the University of Miami’s Miller School of Medicine. “Our findings demonstrate that the same therapies used to slow the onset of diabetes also may help allay the risk of heart disease.”
The randomized clinical trial analyzed blood samples from 1,645 people with impaired glucose tolerance. Participants were randomly assigned to one of three groups – one taking the medication metformin, another taking a placebo and a third undergoing an intensive lifestyle modification program. Researchers compared baseline blood samples from the start of the study to samples taken a year later to measure the interventions’ effects. The study used advanced techniques to obtain a detailed picture of the various particles in the blood.
People who took part in the lifestyle modification program had lower levels of triglycerides and the particles that carry this kind of fat in the blood after a year. Both the metformin and lifestyle interventions were linked to reductions in the number of small low-density lipoprotein (LDL) particles, which carry cholesterol that may contribute to plaque formation, and increases in high-density lipoproteins (HDL), the form of cholesterol that reduces heart disease risk.
“Preventing or slowing the development of diabetes with these treatments also improves the cholesterol and triglyceride profile of a person’s blood,” Goldberg said. “Thanks to the added benefits of existing diabetes interventions, we stand a better chance of lowering the risk of heart disease in this patient population.”
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Other researchers working on the study include: M. Temprosa of George Washington University; J. Otvos of LipoScience, Inc.; J. Brunzell and S. Marcovina of University of Washington; K. Mather of Indiana University School of Medicine; R. Arakaki of University of Hawaii; K. Watson of University of California, Los Angeles; E. Horton of Joslin Diabetes Center; and E. Barrett-Connor of University of California, San Diego.
If you have diabetes or pre-diabetes you have an increased risk for heart disease. Diabetic heart disease can be coronary heart disease (CHD), heart failure, and diabetic cardiomyopathy.
Diabetes by itself puts you at risk for heart disease. Other risk factors include
Family history of heart disease
Carrying extra weight around the waist
Abnormal cholesterol levels
High blood pressure
Smoking
Some people who have diabetic heart disease have no signs or symptoms of heart disease. Others have some or all of the symptoms of heart disease.
Treatments include medications to treat heart damage or to lower your blood glucose (blood sugar), blood pressure, and cholesterol. If you are not already taking a low dose of aspirin every day, your doctor may suggest it. You also may need surgery or some other medical procedure. Lifestyle changes also help. These include a healthy diet, maintaining a healthy weight, being physically active, and quitting smoking.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
The article, “Lifestyle and Metformin Treatment Favorable Influence Lipoprotein Sub-fraction Distribution in the Diabetes Prevention Program,” will be published online on Aug. 27.
Founded in 1916, The Endocrine Society is the world’s oldest, largest and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, The Endocrine Society’s membership consists of over 16,000 scientists, physicians, educators, nurses and students in more than 100 countries. Society members represent all basic, applied and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland.
What is the connection between diabetes, heart disease, and stroke?
If you have diabetes, you are at least twice as likely as someone who does not have diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or have strokes at an earlier age than other people. If you are middle-aged and have type 2 diabetes, some studies suggest that your chance of having a heart attack is as high as someone without diabetes who has already had one heart attack. Women who have not gone through menopause usually have less risk of heart disease than men of the same age. But women of all ages with diabetes have an increased risk of heart disease because diabetes cancels out the protective effects of being a woman in her child-bearing years.
People with diabetes who have already had one heart attack run an even greater risk of having a second one. In addition, heart attacks in people with diabetes are more serious and more likely to result in death. High blood glucose levels over time can lead to increased deposits of fatty materials on the insides of the blood vessel walls. These deposits may affect blood flow, increasing the chance of clogging and hardening of blood vessels (atherosclerosis).
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Jenni Glenn Gingery
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The Endocrine Society