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Diabetes associated with increased cardiovascular disease
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CHICAGO—Men and women with diabetes at age 50 and older appear not to live as long overall, or have as many years without cardiovascular disease, than individuals without diabetes, according to a report in the June 11 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. The benefit is greater in those who had not previously been getting the daily recommended amount of calcium.

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 “Globalization of the Western lifestyle led to Diabetes Mellitus being a major and progressive health care problem worldwide,” the authors write as background information in the article. By 2000, more than 171 million individuals had diabetes—a number that is expected to double in 25 years. Research has shown that individuals with diabetes have an increased risk of illness and death, including double the risk of cardiovascular disease.

Oscar H. Franco, M.D., D.Sc., Ph.D., of University Medical Center Rotterdam, the Netherlands, and Unilever Corporate Research, Sharnbrook, England, and colleagues used data from the Framingham Heart Study, a group of 5,209 men and women age 28 to 62 years recruited between 1948 and 1951 and followed for more than 46 years. The researchers selected three follow-up periods of 12 years each that began in 1956 to 1958, 1969 to 1973, and 1985 to 1989. Participants were followed during each of the three periods until they developed cardiovascular disease or died, and their diabetes status was measured again at the beginning of each interval.

“Women with diabetes had more than double the risk of developing cardiovascular disease and, among those already with cardiovascular disease, mortality compared with non-diabetic women,” the authors write. “Diabetic men, compared with non-diabetic men, had more than double the risk of developing cardiovascular disease and a 1.7 times higher risk of dying once cardiovascular disease was present.” Among those age 50 and older, diabetic men lived an average of 7.5 years less than men without diabetes, and diabetes reduced women’s life expectancy by an average of 8.2 years. Life expectancy free of cardiovascular disease was reduced by 7.8 years in men and 8.4 years in women with diabetes.

“Having diabetes at age 50 years and older represents not only a significant increase in the risk of developing cardiovascular disease and mortality but also an important decrease in life expectancy and life expectancy free of cardiovascular disease,” the authors write. “These findings underscore the importance of diabetes prevention for the promotion of healthy aging. Toward this end, it is essential to implement global strategies to change the current ‘Western’ lifestyle and to promote the adoption of physical activity and healthy diets.”

“Prevention of diabetes is a fundamental task facing today’s society, with the aim to achieve populations living longer and healthier lives,” they conclude.
(Arch Intern Med. 2007;167:1145-1151.

Editor's Note: Co-authors Dr. Franco, Dr. Mackenbach and Dr. Nusselder were partly funded by the Netherlands Organization for Scientific Research. Dr. Hu is a recipient of an American Heart Association Established Investigator Award. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc. 

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