Two Decade Long Study Shows Decline in Cardiovascular Disease Among Diabetics

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Australian researchers have new evidence that patients with diabetes have fewer cardiovascular events today than they did 20 years ago.  The data came from an analysis of the Freemantle diabetes study which compared people with type 2 diabetes to people without diabetes.  The results were recently published in the Journal of Clinical Endocrinology and Metabolism.

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.

A database of hospital records and death records for Western Australia was used to identify cardiovascular complications and deaths among study participants.  They compared the incidence rates (IR) of several outcome measures, including: First hospitalizations for/with myocardial infarction (MI), stroke, heart failure (HF), lower extremity amputation (LEA), and cardiovascular disease (CVD) and all-cause mortality. Five-year IRs, IR ratios (IRRs) for those with versus without diabetes in FDS1 and FDS2, and IR differences (IRDs), were calculated.

What they discovered was that 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.

"Our study found that the rate of cardiovascular complications among individuals with diabetes has declined over the past two decades," said senior author Timothy M.E. Davis, F.R.A.C.P, 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."

However, although the outlook for patients with diabetes is markedly improved, Davis says that there is still cause for concern because death rates from all causes are still higher among diabetics and still need to be monitored.

Wendy A Davis, Edward W Gregg, Timothy M E Davis, Temporal trends in cardiovascular complications in people with or without type 2 diabetes: The Fremantle Diabetes Study, The Journal of Clinical Endocrinology & Metabolism, , dgaa215, https://doi.org/10.1210/clinem/dgaa215