Review Diabetes And Cardiovascular Disease: Insights From The Framingham Heart Study
In 1949, it was noted that “the proper control of diabetes is obviously desirable even though there is uncertainty as to whether coronary atherosclerosis is more frequent or severe in the uncontrolled diabetic” [1]. The role of diabetes in cardiovascular disease (CVD) had been uncertain until the prominent paper published by Kannel and McGee in 1979 [2] identified it as a major risk factor based on evidence from the Framingham Heart Study (FHS), the seminal prospective study of CVD and its determinants. This study provided an update to the FHS, using data that had been collected for 20 years. The results, hence, changed the way healthcare providers thought about diabetes and paved the way for its establishment as a major cardiovascular risk factor. The Kannel and McGee paper is briefly discussed here with its major implications and contributions to subsequent studies. Determinants of CVD from FHS Kannel and McGee studied the Framingham cohort of men and women 45 to 74 years of age at the time of the study who had been followed biennially over a 20-year period. At each biennial examination, participants diagnosed with the defined cardiovascular endpoints were identified. The diagnosis of diabetes in this study was made based on either a history of treatment with oral hypoglycemic agents or insulin, or a random blood glucose level >150 on 2 separate occasions; participants with these characteristics and an abnormal glucose tolerance test were classified as having diabetes. Selection was performed at each biennial examination based on age, status of diabetes, and other characteristics of interest. At each subsequent biennial examination, incidence of cardiovascular events was documented and the participants were then reclassified. The investigators looked at 3 variable Continue reading >>
Diabetes And Cardiovascular Disease Www.idf.org/cvd
Published by the International Diabetes Federation © International Diabetes Federation, 2016 ISBN: 978-2-930229-83-6 EAN: 9782930229836 All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means without the written prior permission of the IDF. Requests to reproduce or translate IDF publications should be addressed to [email protected] Cite this executive summary as: International Diabetes Federation. Diabetes and cardiovascular disease. Brussels, Belgium: International Diabetes Federation, 2016. www.idf.org/cvd Correspondence Dr Lydia Makaroff International Diabetes Federation, 166 Chaussée de La Hulpe, B-1170 Brussels – Belgium [email protected] Design Designed by Anne-Françoise Minique De Visu Digital Document Design – Belgium www.devisu.com Photo credits iStock: p.10 - Shutterstock: p.3 De Visu: p.5 - De Visu + Ingimage: p.12 Support The preparation of this document was made possible through a grant provided by AstraZeneca. The supporter had no influence on the scope or the content of this publication. Beat NCDs The #beatNCDs campaign and symbol are initiatives of the World Health Organization. The symbol is a half ribbon; the four strokes that create it symbolize the four diseases that account for the majority of non-communicable disease deaths worldwide — diabetes, cardiovascular disease, cancer and chronic respiratory disease. The symbol also evokes the idea of legs walking. Main authors David Cavan, International Diabetes Federation, Belgium Jessica Harding, Baker IDI Heart and Diabetes Institute, Australia Ute Linnenkamp, International Diabetes Federation, Belgium Lydia Makaroff, International Diabetes Federation, Belgium Dianna Magliano, Baker IDI Heart and Diabetes Institu Continue reading >>
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- Conjoint Associations of Gestational Diabetes and Hypertension With Diabetes, Hypertension, and Cardiovascular Disease in Parents: A Retrospective Cohort Study
- Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes
Diabetic Heart Disease
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 Continue reading >>
Update On Prevention Of Cardiovascular Disease In Adults With Type 2 Diabetes
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About Delaware’s Diabetes And Heart Disease Programs
The Delaware Diabetes and Heart Disease Prevention and Control Program (DHDPCP) goal is to decrease the state’s emotional, physical, and financial burden from diabetes and heart disease by preventing the diseases and reducing their complications. Our program supports community clinical linkages, health systems interventions, environmental approaches, and epidemiology and surveillance. The program is funded by a cooperative agreement with the Centers for Disease Control and Prevention (CDC), with additional support from the Delaware Health Fund. The program collects and publicizes current, accurate information about diabetes and heart disease, develops approaches for reducing the impact of the diseases, promotes healthy lifestyle habits for prevention and control, and coordinates efforts of public and private health organizations. What we do: program activities Diabetes and Chronic Disease Self-Management Education Programs Emergency Medical Diabetes Fund Diabetes Program provides books and materials in Delaware libraries Publications and Reports Burden of Diabetes in Delaware Burden of Diabetes in Delaware: 2014 Update Original Burden of Diabetes in Delaware report from 2002 Strategic Plans Plan to Prevent and Control Diabetes in Delaware: 2013-2018 [PDF] A Plan To Prevent and Control Diabetes in Delaware: 2002-2010 Data Reports Delaware 2016 data on diabetes from the Behavioral Risk Factor Survey Information and 2015 data about high blood cholesterol in Delaware Resources for Health Professionals Information for school nurses about diabetes-related emergencies [PDF] Materials from national public health campaigns for people with diabetes Resources from the Centers for Disease Control and Prevention (CDC) on preventing Type 2 Diabetes Tool kit for health care teams ab Continue reading >>
Diabetes And Cardiovascular Disease: Pathophysiology Of A Life-threatening Epidemic
Diabetes is associated with the development of premature cardiovascular disease (CVD), which relates to the clustering of risk factors such as dyslipidaemia, hypertension, obesity and hyperglycaemia in the presence of insulin resistance. In addition, diabetes is associated with an inflammatory and pro-thrombotic environment, exacerbating the development of atherothrombosis. Insulin resistance and hyperglycaemia both contribute to the development of endothelial cell dysfunction and increased oxidative stress, culminating in accelerated atherosclerosis. Clot formation and function are also directly affected by insulin resistance and hyperglycaemia, with increased levels of coagulation factors and anti-fibrinolytic proteins and a fibrin network that is more resistant to lysis, coupled with increased platelet activation.It is well recognised that the intensification of glycaemic control leads to a reduction in microvascular complications in type 1 and type 2 diabetes; however, the same is less clear with macrovascular disease. Several randomised studies have attempted to address the effect of short-, medium- and long-term glycaemic control on cardiovascular outcomes, with mixed results. The overall interpretation of these trials suggests that intensive glycaemic control in patients with a relatively short duration of diabetes, without very poor control and with no CVD, might be safe and associated with fewer cardiovascular events.This review will summarise the effects of hyperglycaemia on the development of atherothrombosis and examine key cardiovascular outcome trials following intensive glucose control. Do you want to read the rest of this article? ... Vascular smooth muscle cell (VSMC) migration from the medial layer to the intimal layer, which under normal circumstance Continue reading >>
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- Conjoint Associations of Gestational Diabetes and Hypertension With Diabetes, Hypertension, and Cardiovascular Disease in Parents: A Retrospective Cohort Study
- Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes
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C ur re nt D ia be te s R ev ie w s ������ �������� ������� ������ � ������� ���� � U. Shrivastava1-3, A. Misra*1-4, V. Mohan5, R. Unnikrishnan5 and D. Bachani6 1Centre for Public Health India, New Delhi, India; 2National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India; 3Diabetes Foundation (India), New Delhi, India; 4Fortis C-DOC Hospital for Diabetes, Metabolic Diseases and Endocrinology, New Delhi, India; 5Dr. Mohan’s Diabetes Specialties Centre and Madras Diabetes Research Founda- tion, Chennai, India; 6Ministry of Health and Family Welfare, Government of India A R T I C L E H I S T O R Y DOI: 10.2174/1573399812666160805153 328 Abstract: Non-communicable diseases (NCDs; including coronary heart disease and type 2 diabe- tes) are rapidly increasing in India causing nearly 5.8 million deaths per year. Primary reasons for rise in NCDs in India are nutrition and lifestyle transitions. Further, presence of higher body fat, ab- dominal fat, liver and pancreatic fat and lower lean mass than whites, contribute to heightened meta- bolic and cardiovascular risk in Asian Indians. Importantly, conversion from pre-diabetes to diabetes occurs more rapidly, and reversion to normal glucose regulation with appropriate lifestyle measures is more difficult in Asian Indians than white population. Huge number of patients with diabetes and with complications increase morbidity, mortality and pose substantial economic burden. It is diffi- cult, though not impossible, to decrease pace of rapidly expanding juggernaut of NCDs in India. Only concerted efforts from multiple s Continue reading >>
Gout, Diabetes And Cardiovascular Disease In The Aotearoa New Zealand Adult Population: Co-prevalence And Implications For Clinical Practice
Gout, diabetes and cardiovascular disease in the Aotearoa New Zealand adult population: co-prevalence and implications for clinical practice 25th January 2013, Volume 126 Number 1368 Doone Winnard, Craig Wright, Gary Jackson, Peter Gow, Andrew Kerr, Andrew McLachlan, Brandon Orr-Walker, Nicola Dalbeth Gout is the most common inflammatory arthritis affecting men. This disease typically presents as recurrent self-limiting episodes of severe joint inflammation affecting the feet, described by patients as like a fire in the joints.1 Gout may result in significant work and social disability.13Gout and hyperuricaemia have also been associated with insulin resistance and increased risk of hypertension, diabetes and cardiovascular disease (CVD). The exact role of serum urate in these conditions remains subject to investigation,4but it has been suggested that the onset of gouty arthritis can identify a clinical population likely to have coincident metabolic risk5,6and can therefore be an important opportunity for intervention to modify subsequent disease trajectories.7 Aotearoa New Zealand has one of the highest documented prevalences of gout worldwide, with very high rates in Mori and Pacific men.811We have recently confirmed these findings in a study of the entire Aotearoa New Zealand population using the Aotearoa New Zealand Health Tracker (ANZHT) health dataset.12 The aim of this study was to investigate the co-prevalence of gout, diabetes and CVD in the Aotearoa New Zealand adult population to inform clinical practice. Study populationThe Aotearoa New Zealand Health Tracker (ANZHT) population was used to determine the prevalence of gout, diabetes and CVD in those aged 20 years,with stratification by age, gender, and ethnicity. The ANZHT population is based on health servic Continue reading >>
- Early Glycemic Control and Magnitude of HbA1c Reduction Predict Cardiovascular Events and Mortality: Population-Based Cohort Study of 24,752 Metformin Initiators
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- The UK Prospective Diabetes Study (UKPDS): clinical and therapeutic implications for type 2 diabetes
Diabetes And Cardiovascular Disease
Part of the Contemporary Cardiology book series (CONCARD) Aresh J. Anwar, Anthony H. Barnett, Sudhesh Kumar A. Enrique Caballero, Su Chi Lim, Edward S. Horton, Aristidis Veves Lawrence H. Young, Raymond R. Russell III, Deborah Chyun, Tarik Ramahi With over ten million diagnosed patients and another five million undiagnosed, diabetes mellitus and its complications-cardiovascular disease, nephropathy, neuropathy, and retinopathy-is a major public health problem that will assume epidemic proportions as the population grows older. In Diabetes and Cardiovascular Disease, Michael T. Johnstone, md, and Aristidis Veves, md, dsc, have assembled a panel of seasoned clinicians and expert scientists to comprehensively review both the clinical and scientific aspects of diabetic cardiovascular disease. The contributors thoroughly discuss the mechanisms and risk factors of diabetes in relation to hypertension, dyslipidemia, thrombosis, atherosclerosis, coronary artery disease, and congestive heart failure. Their review includes a full examination of the epidemiology, mechanisms, methods of assessment, and treatment of the disease at the macrovascular level, and a discussion of its microvascular effects, including retinopathy, nephropathy, neuropathy, and compromised microcirculation in the diabetic foot. Each chapter covers its topics in great detail and is accompanied by extensive references. Comprehensive and up-to-date, Diabetes and Cardiovascular Disease offers not only practicing physicians the day-to-day practical knowledge needed to treat patients effectively, but also clinical scientists a deeper understanding for developing novel therapies for this devastating illness. Continue reading >>
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- Conjoint Associations of Gestational Diabetes and Hypertension With Diabetes, Hypertension, and Cardiovascular Disease in Parents: A Retrospective Cohort Study
- Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes
Cardiovascular Disease
Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels.[2] Cardiovascular disease includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack).[2] Other CVDs include stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, heart arrhythmia, congenital heart disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery disease, thromboembolic disease, and venous thrombosis.[2][3] The underlying mechanisms vary depending on the disease in question.[2] Coronary artery disease, stroke, and peripheral artery disease involve atherosclerosis.[2] This may be caused by high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, and excessive alcohol consumption, among others.[2] High blood pressure results in 13% of CVD deaths, while tobacco results in 9%, diabetes 6%, lack of exercise 6% and obesity 5%.[2] Rheumatic heart disease may follow untreated strep throat.[2] It is estimated that 90% of CVD is preventable.[5] Prevention of atherosclerosis involves improving risk factors through: healthy eating, exercise, avoidance of tobacco smoke and limiting alcohol intake.[2] Treating risk factors, such as high blood pressure, blood lipids and diabetes is also beneficial.[2] Treating people who have strep throat with antibiotics can decrease the risk of rheumatic heart disease.[6] The effect of the use of aspirin in people who are otherwise healthy is of unclear benefit.[7][8] Cardiovascular diseases are the leading cause of death globally.[2] This is true in all areas of the world except Africa.[2] Together they resulted in 17.9 million deaths (32.1%) in 2015, up from 12.3 million (25.8%) in 1990.[4] Continue reading >>
Lowering Cardiovascular Disease Risk For Patients With Diabetes
BACKGROUND Pharmacists are in the unique position to not only educate patients about diabetes but also discuss the preventable complications that can stem from diabetes. Specifically, pharmacists can help to address risk factors that contribute to cardiovascular disease, such as hypertension, lipid levels, and antiplatelet agents and offer lifestyle modifications when reviewing medications and counseling their patients about this chronic health disease. The CDC 2017 National Diabetes Statistics Report estimated that over 30 million individuals, or 9.4% of the US population, have diabetes.1 Of these 30 million people, about 25% do not have a diabetes diagnosis.1 In 2015, diabetes was the seventh leading cause of death, with heart disease as the leading cause.2 The contributing factors to these statistics include the complications that accompany diabetes, such as heart disease and stroke; eye problems that can lead to blindness; and kidney disease and amputations. There is a strong correlation between diabetes and cardiovascular disease (CVD), which is the leading cause of death in patients with diabetes.3 In fact, at least 68% of adults >65 years with diabetes die from some form of heart disease, and adults with diabetes are 2 to 4 times more likely to die from heart disease than adults without the condition (figure 14).5,6 Pharmacists should ensure that patients have access to all the resources needed to control blood glucose and glycated hemoglobin and should edu- cate patients to ensure they take the steps necessary to minimize risks for complications. Even when glucose is controlled, patients with diabetes have an increased risk of heart disease and stroke, as there are often other risk factors present that contribute to CVD, such as hypertension, dyslipidemia, obesi Continue reading >>
- Lowering Cardiovascular Disease Risk for Patients With Diabetes
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- Conjoint Associations of Gestational Diabetes and Hypertension With Diabetes, Hypertension, and Cardiovascular Disease in Parents: A Retrospective Cohort Study
Diabetes & Heart Health | Minnesota Diabetes And Heart Health Collaborative
Make the Link and be smart about your heart! Cardiovascular disease (CVD) is the number one cause of death in people with diabetes. Yet two-thirds of patients do not consider CVD to be a serious complication of their diabetes. Make the Link and be smart about your heart! patient handouts 3 different colorful, one-page sheets with easy to read facts, tips and resource links Sample news release People with Diabetes Can Reduce their Risk of Heart Disease and Stroke [DOC/37KB] Controlling blood pressure can help protect a person with diabetes from heart attack, stroke, blindness and kidney disease. Take these simple steps to control high blood pressure. This campaign was adopted from the Minnesota Health Plan/DHS Performance Improvement Project for Diabetes and High Blood Pressure. Handout: Put the Squeeze on High Blood Pressure Medication Log [PDF/176KB] A tri-fold sheet (8.5x17) with tips for taking blood pressure control medicines and keeping track of medication issues. [JPG/100KB- Click image for full-size] Includes the message along with a high blood pressure reading using the same colorful graphics as the Put the Squeeze on High Blood Pressure campaign. Image: 128/74 Blood Pressure Reading [JPG/36KB- Click image for full-size] Depicts a gauge with a normal blood pressure reading using the same colorful graphics as the Put the Squeeze on High Blood Pressure campaign. Facts about High Blood Pressure and Sodium (salt) in Your Diet Eating a lot of high sodium (salty) foods can cause high blood pressure, leading to heart disease and stroke. Some foods have a lot of sodium: bread, cured meats, soups, pizza, cheese, packaged meals and snack chips, pretzels, and popcorn. Americans eat too much sodium more than twice the recommended amount for most adults (1500 mg a day). To Continue reading >>
Metabolite Signatures Of Diabetes With Cardiovascular Disease: A Pilot Investigation
Metabolite signatures of diabetes with cardiovascular disease: a pilot investigation Type 2 diabetes (T2D) is an independent risk factor in the development of cardiovascular disease. However, there are significant limitations in the de... Genetic analysis of haptoglobin polymorphisms with cardiovascular disease and type 2 diabetes in the diabetes heart study Haptoglobin (HP) is an acute phase protein that binds to freely circulating hemoglobin. HP exists as two distinct forms, HP1 and HP2. The longer HP2 form has been associated with cardiovascular (CVD) events and mortality in individuals with type 2 di Metformin is the most-prescribed oral medication to lower blood glucose worldwide. Yet previous systematic reviews have raised doubts about its effectiveness in reducing risk of cardiovascular disease, the most costly complication of type 2 diabetes. Metabolomics (2017) 13:154 DOI 10.1007/s11306-017-1278-8 Metabolite signatures ofdiabetes withcardiovascular disease: apilot investigation LavanyaReddivari1 BishwaR.Sapkota2,3,4 ApoorvaRudraraju1 YundiLiang6 ChristopherAston2 EvgenySidorov4,5 JairamK.P.Vanamala6,7 DharambirK.Sanghera2,3,4,8 Received: 6 April 2017 / Accepted: 22 September 2017 Springer Science+Business Media, LLC 2017 Abstract Introduction Type 2 diabetes (T2D) is an independent risk factor in the development of cardiovascular disease. However, there are significant limitations in the detection of the metabolic disturbances in hyperglycemia that lead to vascular dysfunction. Objectives The goals of the study were: (i) to identify circulating metabolites discriminating T2D and normoglycemia, and (ii) to assess phenotypic correlations of identified metabolites with other cardiometabolic risk traits (CMTs). Methods We have generated global and targeted metabol Continue reading >>
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- Conjoint Associations of Gestational Diabetes and Hypertension With Diabetes, Hypertension, and Cardiovascular Disease in Parents: A Retrospective Cohort Study
- Diabetes and cardiovascular disease: A deadly duo
Impact Of Diabetes On Cardiovascular Disease: An Update
Copyright © 2013 Alessandra Saldanha de Mattos Matheus et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Cardiovascular diseases are the most prevalent cause of morbidity and mortality among patients with type 1 or type 2 diabetes. The proposed mechanisms that can link accelerated atherosclerosis and increased cardiovascular risk in this population are poorly understood. It has been suggested that an association between hyperglycemia and intracellular metabolic changes can result in oxidative stress, low-grade inflammation, and endothelial dysfunction. Recently, epigenetic factors by different types of reactions are known to be responsible for the interaction between genes and environment and for this reason can also account for the association between diabetes and cardiovascular disease. The impact of clinical factors that may coexist with diabetes such as obesity, dyslipidemia, and hypertension are also discussed. Furthermore, evidence that justify screening for subclinical atherosclerosis in asymptomatic patients is controversial and is also matter of this review. The purpose of this paper is to describe the association between poor glycemic control, oxidative stress, markers of insulin resistance, and of low-grade inflammation that have been suggested as putative factors linking diabetes and cardiovascular disease. 1. Introduction Diabetes is an important chronic disease which incidence is globally increasing and though considered as an epidemic [1]. The World Health Organization (WHO) estimated there were 30 million people who had diabetes worldwide in 1985. This number increased to 135 Continue reading >>
- Impact of metformin on cardiovascular disease: a meta-analysis of randomised trials among people with type 2 diabetes
- Impact of menopause and diabetes on atherogenic lipid profile: is it worth to analyse lipoprotein subfractions to assess cardiovascular risk in women?
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
Prevention Of Diabetes And Heart Disease
Background There are gaps between current clinical guideline recommendations and current practice for the prevention of diabetes and heart disease. This study aims to explore patients’ views on risk, assessment and their general practitioner’s role, and how these factors may impact their uptake of preventive care. Methods A qualitative study was conducted using semi-structured telephone interviews with 18 patients from three general practices in New South Wales. Results Patients associated the GPs’ role with their experience of their GP’s actions. Most patients saw their GP’s primary role as assessing single physiological risk factors. Test results influenced patients’ perception of their risk, motivating them to make changes and engage in prevention. However, none recalled having multi-factorial assessments and those with normal results were infrequently offered lifestyle advice. Discussion Patient engagement in prevention could be promoted by multi-factorial risk assessments and communication of risk, and appropriate advice and follow up delivered by their GP or practice nurse. The consensus approach to prevention of heart disease and type 2 diabetes mellitus (T2DM) involves the combination of early risk identification and implementing intervention strategies.1 Current guidelines for the adult Australian population2 recommend patient assessment by the Australian Cardiovascular Risk Charts3 and the Australian Type 2 Diabetes Risk Assessment Tool (AusDrisk),4 which are risk assessment tools tailored to the Australian population. However, there is limited use of these tools in the Australian general practice setting, estimated to be as low as 40% and 14% respectively.5,6 The low uptake may be attributed to the newness of the development and introduction of th Continue reading >>
