Two-decade study shows overall mortality risk remains higher than general population
The rate of heart attacks, strokes and other cardiovascular complications has improved among people with diabetes over the past 20 years, narrowing the gap in cardiovascular mortality rates between individuals with and without diabetes, according to a new study published in The Journal of Clinical Endocrinology & Metabolism.
More than 463 million adults worldwide have diabetes, according to the International Diabetes Federation. Adults with diabetes have a two- to three-fold increased risk of heart attacks and strokes compared to adults who do not have the condition, according to the World Health Organization.
“Our study found that the rate of cardiovascular complications among individuals with diabetes has declined over the past two decades,” says senior author Timothy M.E. Davis, FRACP, of the University of Western Australia and Fremantle Hospital in Fremantle, Australia. “While we’ve seen improvements in cardiovascular disease outcomes in the general population during the same time period, the gains in individuals with diabetes outpaced the general population during that timeframe.”
The researchers analyzed data from two phases of the Fremantle Diabetes Study, which took place 15 years apart. The first phase, which ran from 1993 to 2001, compared data on 1,291 individuals with type 2 diabetes to 5,159 residents without the condition. During the second phase from 2008 to 2016, researchers collected data from 1,509 participants with type 2 diabetes and compared outcomes to 6,036 individuals who did not have the condition.
The researchers used a database of hospital records and death records for Western Australia to identify cardiovascular complications and deaths among study participants.
Individuals with diabetes in the Fremantle Diabetes Study’s second phase were less likely to experience a heart attack or stroke, be hospitalized for heart failure, or be hospitalized for a lower extremity amputation than their counterparts in the first phase.
“While the outlook for people with diabetes in developed countries is improving significantly, we remain concerned that the death rate from all causes among people with diabetes is worse than the general population,” Davis says. “The trend shows we still have to monitor conditions like cancer and dementia that may become an issue for people with diabetes later in life.”
The study’s co-authors are Wendy A. Davis of the University of Western Australia and Fremantle Hospital in Fremantle, Australia, and Edward W. Gregg of Imperial College London in the U.K.
The first cohort was supported by the Raine Foundation, University of Western Australia, and the second cohort was supported by the National Health and Medical Research Council (Project Grants 513781 and 1042231). Timothy Davis’ work is supported by a Medical Research Future Fund Practitioner Fellowship.
The manuscript, “Temporal Trends in Cardiovascular Complications in People with or without Type 2 Diabetes: The Fremantle Diabetes Study,” was published online, ahead of print.
The Hormone Health Network, the Society’s public education arm, offers additional resources on diabetes and cardiovascular disease.