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Early Diabetes Intervention May Lead to a Great Reduction in Cardiovascular Risk

The American Diabetes Association held its 74th Scientific Session in June 2014, in San Francisco, California.  It brought together more than 700 speakers, and over 17,000 attenders, with many, many topics of discussion and interest. Among many of these, was the topic of cardiovascular risk and its potential reduction by means of preventative measures such as lifestyle changes, and medications.1

How to measure risk of heart disease?

Studies done by Leigh Perreault, MD, of the University of Colorado Denver School of Medicine in Aurora, used the Framingham score method as a way to assess risk among individuals (pre-diabetics, those who were restored to normal glucose levels, and diabetics) over a 10 year period.  The Framingham score is basically a calculator that uses some basic variables in a person’s health to determine their potential risk for a cardiovascular event within the next 10 years. These variables include: age, gender, total cholesterol, HDL (or good cholesterol), smoker status, and systolic blood pressure.  (You can assess your own risk with the National Heart, Lung, and Blood Institute’s Framingham Score calculator. )

In the beginning, pre-diabetics showed the highest risk score, but intervention and restoration of glucose levels showed a 28 percent lower occurrence in macrovascular complications than those who did go on to develop diabetes over a 10 year period. Medication as an intervention also greatly reduced this risk. (It is important to note that the Framingham score has some limitations. It only attempts to predict future coronary heart disease (CHD) events, but not future total cardiovascular events, such as risk for stroke, transient ischemic attack (TIA), and heart failure).2

Connection between high blood glucose and heart disease

This study done by Perreault underscores some of the things that we know about diabetes: elevated glucose levels greatly increase cholesterol levels, which may increase the risk for cardiovascular issues. It is, in essence, like a domino effect. When our bodies are unable to process glucose efficiently, they produce even more insulin to try to address the issue – eventually storing much of that glucose as fat. One of insulin’s many functions is to store fat, thus excess glucose and insulin lead to more fat stores, especially around the liver and midsection, which lead to higher cholesterol levels.  For these reasons, a person with diabetes is two to four times more likely to develop heart disease.

How to reduce heart disease risk

It is, therefore, imperative that people with impaired glucose levels be diagnosed as early as possible. The problem, of course, is in creating mindfulness – but not just among patients. It is essential that clinicians and other medical professionals become more aware of the early signs of diabetes, and the proper diagnostic tools. Most persons with diabetes are diagnosed when they’ve already been living for years with the condition, with symptoms often being ignored or attributed to other factors such as aging.  Patients may also be wrongly diagnosed as pre-diabetic, because of a lack of knowledge of the major diabetes organizations’ recommendations for healthy blood glucose levels, as well as usage of the wrong diabetes diagnostic tools. (Since high blood glucose levels may not be chronically elevated for a person with pre-diabetes or early stages of diabetes, they would best be served by a glucose tolerance test, rather than an A1C – which is considered the golden standard in diagnostics – for example).

One thing was unequivocal, though: prediabetic or not, intervention and normalization of blood glucose levels will help reduce a person with diabetes’ future potential risk for cardiovascular events. Taking the necessary baby steps of checking one’s blood glucose, balancing carbohydrates through the day, exercising and taking our medications, is essential in our overall health.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.