Short-term delays in diabetes onset confer long-term cardioprotective effects
medwireNews: Delaying diabetes onset by at least 6 years in people with impaired glucose tolerance (IGT) significantly reduces their risk for cardiovascular disease (CVD) and microvascular complications, show 30-year data from the Da Qing Diabetes Prevention Study.
The findings presented by Guangwei Li (Fuwai Hospital, Beijing, China) at the 79th ADA Scientific Sessions in San Francisco, California, USA, showed that the 30-year cumulative incidence of CVD, namely nonfatal or fatal stroke, myocardial infarction, or hospitalization for heart failure (HHF) was 46.1% among the 174 patients who reverted from IGT to normal glucose tolerance following a 6-year lifestyle intervention.
This compared with an incidence of 50.6% among the 114 patients who still had IGT at the end of the intervention and 65.6% among the 252 who developed diabetes during the intervention.
The corresponding rates of microvascular complications (first occurrence of severe retinopathy, nephropathy, or neuropathy) were 23.1%, 31.2%, and 44.3%.
After adjustment for multiple baseline risk factors including age and sex, Li and team found that individuals who developed diabetes had a significant 1.57-fold higher risk for CVD and a 2.53-fold higher risk for microvascular complications relative to those who reverted to normal glucose tolerance.
Among the individual components of each outcome, patients who developed diabetes had significantly higher risks for stroke (HR=1.52), HHF (HR=2.53), and severe retinopathy (HR=3.26), but not myocardial infarction, nephropathy, or neuropathy, relative to those who reverted to normal glucose tolerance.
Speaking at a press conference, Li said the findings show that “the magnitude of serious long-term complications associated with IGT is much greater in people whose glucose tolerance worsens rapidly to diabetes than in those who retain nondiabetic levels in earlier years.”
He continued: “If that progression can be reversed or delayed for 6 years or more, the likelihood of developing long-term serious CVD and microvascular disease is much reduced.”
Li concluded that the data “further reinforce and are consistent with the thesis that the longer the progression to diabetes can be delayed, the fewer the complications.”
The Da Qing Diabetes Prevention Outcome Study findings were simultaneously reported in The Lancet Diabetes & Endocrinology.
By Laura Cowen
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