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Hyperglycemia and cardiovascular disease

Hyperglycemia and cardiovascular disease

Hubert HB, Feinleib M, McNamara PM, Castelli Hyperglycemia and cardiovascular disease. Article PubMed CAS Google Scholar Rabkin SW, Hypertlycemia FA, Hsu PH. Am J Epidemiol. Google Scholar. Risk Factors: Diabetes High blood pressure High LDL bad cholesterol and triglycerides Low HDL good cholesterol Too little physical activity Smoking Being overweight or obese.

Hyperglycemia and cardiovascular disease -

In the Asian Pacific Study, fasting plasma glucose was shown to be an independent predictor of cardiovascular events up to a level of ~5. A fresh look at old facts the importance of peaks and valleys, or in scientific terms, of quality of glucohomeostasis was possible when reliable and precise continuous glucose measurement systems became available for clinical use.

As shown by Monnier et al. Already in , our group could show in the Risk Factors in IGT for Atherosclerosis and Diabetes study that parameters of glycemic variability instead of A1C were significantly related to carotid intima-media thickness Today, we have consistent data from pathophysiological investigations that glucose fluctuations may be a vascular risk factor in its own right.

Glucose fluctuations and hyperglycemia are triggers for inflammatory responses via increased mitochondrial superoxide production 11 and endoplasmic reticulum stress The inflammatory responses induced by one transient short-term episode of hyperglycemia might last for several days Inflammation leads to insulin resistance 14 and β-cell dysfunction, which further aggravates hyperglycemia.

The molecular pathways that integrate hyperglycemia, oxidative stress, and diabetic vascular complications have been most clearly described in the pathogenesis of endothelial dysfunction According to the response to injury hypothesis, endothelial dysfunction represents the first step of atherogenesis The results of these molecular investigations were confirmed by studies in patients.

Acute hyperglycemia rapidly attenuated endothelium-dependent vasodilation 17 , 18 and reduced myocardial perfusion Thus, direct effects of glucotoxicity, oxidative stress, and low-grade inflammation act in a vicious circle that impairs insulin sensitivity, accelerates and escalates loss of β-cells, impairs endothelial function, and leads to microvascular and macrovascular disease.

Because pathophysiological and epidemiological evidence demonstrated a direct link between hyperglycemia and cardiovascular or all-cause mortality in type 2 diabetic patients, one could expect a risk reduction by glucose-lowering treatment strategies.

However, the results of large clinical trials investigating the potential of improved glycemic control to reduce cardiovascular events are not fully convincing. Three mega-trials in patients with type 2 diabetes—the Action to Control Cardiovascular Risk in Diabetes ACCORD study 20 , the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation ADVANCE 21 , and the Veterans Affairs Diabetes Trial VADT 22 —were recently conducted to clarify whether lowering blood glucose to near-normal levels will reduce cardiovascular risk.

All of these trials included older patients with a diabetes duration of 8— One-third of the patients have had a history of cardiovascular disease. Despite an acceptable glycemic control in the intensified treatment arm ACCORD: A1C 6.

standard treatment, respectively , none of these trials showed a significant difference of cardiovascular events between the patients receiving intensified treatment and those receiving standard treatments. Speculation about the reasons for these disappointing results has been published; however, there is not yet a convincing explanation.

A common hypothesis attributed the excess mortality to the higher rate of hypoglycemia in the intensified treatment group. However, as demonstrated by our group using continuous glucose monitoring, the rate of hypoglycemia is not inevitably related to A1C Interestingly, some new post hoc analyses of the ACCORD study, which has been terminated early because of excess mortality in the intensified treatment arm, indicated a decrease of cardiovascular mortality in patients who indeed reached the target A1C value of 6.

In other words, a low A1C itself did not necessarily mean a higher mortality rate. Some baseline conditions of patients participating in the ACCORD trial might have contributed to cardiovascular mortality, e. These conditions clearly increase the risk for hypoglycemia or hypoglycemia unawareness and hypoglycemia-induced myocardial damage.

Another aspect to consider is the low rate of mortality, especially in the standard treated patients Table 1 compared with the Steno-2 study 26 , another landmark trial, despite the similar age of patients at the end of the trials.

This finding reflects the high grade of care for concomitant disorders e. However, based on epidemiological data, the mortality rate of standard care patients in these trials was still twice as high as in healthy people 5.

However, a significant benefit of intensified glucose-lowering treatment for all-cause mortality could be shown in patients with newly diagnosed type 2 diabetes during long-term follow-up of the Diabetes Intervention Study, as shown in Fig.

Selected baseline characteristic of patients age, A1C, blood pressure, and LDL cholesterol , cardiovascular end point, and yearly mortality rate of recent large prospective intervention studies with regard to glycemic control.

Diabetes Intervention Study year follow-up: incidence of myocardial infarction MI and all-cause mortality by quality of glycemic control. Fasting blood glucose values A and postprandial blood glucose values B good control. Only a subpopulation of obese patients who were intensively treated with metformin had a cardiovascular benefit These results suggest a legacy effect of good glycemic control if initiated during the early stages of type 1 as well as type 2 diabetes.

We conclude that hyperglycemia is still a key cardiovascular risk factor for patients with type 2 diabetes, and treatment of hyperglycemia to near-normal levels might reduce cardiovascular events and mortality of these patients if we consider several aspects: 1 an early initiation of treatment seems to be necessary, 2 hypoglycemia should be avoided, and 3 an individualized therapeutic regimen should be developed, taking into account concomitant diseases and the individual risk profile.

This publication is based on the presentations at the 3rd World Congress on Controversies to Consensus in Diabetes, Obesity and Hypertension CODHy. The Congress and the publication of this supplement were made possible in part by unrestricted educational grants from AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Eli Lilly, Ethicon Endo-Surgery, Generex Biotechnology, F.

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Skip Nav Destination Close navigation menu Article navigation. Previous Article Next Article. Article Navigation. Diabetes and Cardiovascular Disease April 22 Is Hyperglycemia a Cardiovascular Risk Factor?

Frank Pistrosch, MD ; Frank Pistrosch, MD. This Site. Google Scholar. Andrea Natali, MD ; Andrea Natali, MD. Markolf Hanefeld, MD Markolf Hanefeld, MD.

Corresponding author: Markolf Hanefeld, hanefeld gwtonline-zks. Get Permissions. toolbar search Search Dropdown Menu. toolbar search search input Search input auto suggest. Table 1 Selected baseline characteristic of patients age, A1C, blood pressure, and LDL cholesterol , cardiovascular end point, and yearly mortality rate of recent large prospective intervention studies with regard to glycemic control.

ACCORD Yeboah, J. Development of a new diabetes risk prediction tool for incident coronary heart disease events: the Multi-Ethnic Study of Atherosclerosis and the Heinz Nixdorf Recall Study. Atherosclerosis , — Cosentino, F. ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD.

van der Leeuw, J. The validation of cardiovascular risk scores for patients with type 2 diabetes mellitus. Read, S. Performance of cardiovascular disease risk scores in people diagnosed with type 2 diabetes: external validation using data from the National Scottish Diabetes Register.

Diabetes Care 41 , — Segar, M. Machine learning to predict the risk of incident heart failure hospitalization among patients with diabetes: the WATCH-DM risk score. Yang, P. Development of a risk score for atrial fibrillation in adults with diabetes mellitus from the ACCORD Study. Slieker, R. Performance of prediction models for nephropathy in people with type 2 diabetes: systematic review and external validation study.

Beulens, J. Prognostic models for predicting the risk of foot ulcer or amputation in people with type 2 diabetes: a systematic review and external validation study.

van der Heijden, A. Prediction models for development of retinopathy in people with type 2 diabetes: systematic review and external validation in a Dutch primary care setting.

Diabetologia 63 , — Grundy, S. Kuller, L. Diabetes mellitus: subclinical cardiovascular disease and risk of incident cardiovascular disease and all-cause mortality. Brohall, G. Carotid artery intima-media thickness in patients with type 2 diabetes mellitus and impaired glucose tolerance: a systematic review.

Alves-Cabratosa, L. Levels of ankle-brachial index and the risk of diabetes mellitus complications. BMJ Open Diabetes Res. Care 8 , e Cardoso, C. Prognostic impact of the ankle-brachial index on the development of micro- and macrovascular complications in individuals with type 2 diabetes: the Rio de Janeiro Type 2 Diabetes Cohort Study.

Diabetologia 61 , — Den Ruijter, H. Common carotid intima-media thickness measurements in cardiovascular risk prediction: a meta-analysis. Impact of subclinical atherosclerosis on cardiovascular disease events in individuals with metabolic syndrome and diabetes: the Multi-Ethnic Study of Atherosclerosis.

Diabetes Care 34 , — Nambi, V. Carotid intima-media thickness and presence or absence of plaque improves prediction of coronary heart disease risk: the ARIC Atherosclerosis Risk In Communities study.

The metabolic syndrome, diabetes, and subclinical atherosclerosis assessed by coronary calcium. Coronary artery calcium score for long-term risk classification in individuals with type 2 diabetes and metabolic syndrome from the multi-ethnic study of atherosclerosis.

JAMA Cardiol. Sex differences in coronary artery calcium and mortality from coronary heart disease, cardiovascular disease, and all causes in adults with diabetes: the Coronary Calcium Consortium.

Metabolic syndrome, diabetes, and incidence and progression of coronary calcium: the Multiethnic Study of Atherosclerosis study. JACC Cardiovasc. Imaging 5 , Chen, K. Independent associations between metabolic syndrome, diabetes mellitus and atherosclerosis: observations from the Dallas Heart study.

Sow, M. Prevalence, determinants and prognostic value of high coronary artery calcium score in asymptomatic patients with diabetes: a systematic review and meta-analysis. Kramer, C. Coronary artery calcium score prediction of all-cause mortality and cardiovascular events in people with type 2 diabetes: systematic review and meta-analysis.

Knuuti, J. ESC guidelines for the diagnosis and management of chronic coronary syndromes. Greenland, P. Improved cardiovascular risk factors control associated with a large-scale population management program among diabetes patients. Composite cardiovascular risk factor target achievement and its predictors in US adults with diabetes: the Diabetes Collaborative Registry.

Andary, R. Control of cardiovascular risk factors among US adults with type 2 diabetes with and without cardiovascular disease. El Sayed, N. Cardiovascular disease and risk management: standards of care in diabetes— Diabetes Care 46 , S—S Cardiovascular risk factor targets and cardiovascular disease event risk in diabetes: a pooling project of the atherosclerosis risk in communities study, multi-ethnic study of atherosclerosis, and Jackson heart study.

Diabetes Care 39 , — Wright, A. Risk factor control and cardiovascular event risk in people with type 2 diabetes in primary and secondary prevention settings. Preventable coronary heart disease events from control of cardiovascular risk factors in US adults with diabetes projections from utilizing the UKPDS risk engine.

Chaitman, B. The bypass angioplasty revascularization investigation 2 diabetes randomized trial of different treatment strategies in type 2 diabetes mellitus with stable ischemic heart disease: impact of treatment strategy on cardiac mortality and myocardial infarction.

Gaede, P. Effect of a multifactorial intervention on mortality in type 2 diabetes. Vaag, A. Glycemic control and prevention of microvascular and macrovascular disease in the Steno 2 study.

Ueki, K. Effect of an intensified multifactorial intervention on cardiovascular outcomes and mortality in type 2 diabetes J-DOIT3 : an open-label, randomised controlled trial. Davies, M. Management of hyperglycemia in type 2 diabetes, A consensus report by the American Diabetes Association ADA and the European Association for the Study of Diabetes EASD.

Diabetes Care 45 , — McGuire, D. Association of SGLT2 inhibitors with cardiovascular and kidney outcomes in patients with type 2 diabetes: a meta-analysis. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of randomised trials.

Vaduganathan, M. SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials. Packer, M. Rapid evidence-based sequencing of foundational drugs for heart failure and a reduced ejection fraction.

Heart Fail. Mark, P. Implementation, not hesitation, for SGLT2 inhibition as foundational therapy for chronic kidney disease. National Institute for Health and Care Excellence.

Verma, S. SGLT2 inhibitors and mechanisms of cardiovascular benefit: a state-of-the-art review. US National Library of Medicine. Jesuthasan, A.

Sex differences in intraorgan fat levels and hepatic lipid metabolism: implications for cardiovascular health and remission of type 2 diabetes after dietary weight loss. Diabetologia 65 , — Type 2 diabetes-related sex differences in cardiovascular risk: reasons, ramifications, and clinical realities.

Age-, sex- and ethnicity-related differences in body weight, blood pressure, HbA 1c and lipid levels at the diagnosis of type 2 diabetes relative to people without diabetes. Age at diagnosis of type 2 diabetes mellitus and associations with cardiovascular and mortality risks.

Management of hyperglycaemia in type 2 diabetes, Type 2 diabetes in migrant south Asians: mechanisms, mitigation, and management. Download references. Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, CA, USA. Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.

You can also search for this author in PubMed Google Scholar. Correspondence to Nathan D. Wong or Naveed Sattar. receives research support through his institution from Eli Lilly, Novartis and Novo Nordisk.

has also received grants funding, paid to his University, from AstraZeneca, Boehringer Ingelheim, Novartis and Roche Diagnostics. Nature Reviews Cardiology thanks Joline Beulens, Heinz Drexel and the other, anonymous, reviewer s for their contribution to the peer review of this work.

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Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily. Skip to main content Thank you for visiting nature. nature nature reviews cardiology review articles article. Subjects Cardiology Endocrinology. Abstract Cardiovascular diseases CVDs are the leading causes of morbidity and mortality in individuals with type 2 diabetes mellitus T2DM.

Key points Cardiovascular diseases CVDs are the leading cause of morbidity and mortality in individuals with type 2 diabetes mellitus T2DM. Access through your institution.

Buy or subscribe. Change institution. Learn more. References Blair, M. PubMed Google Scholar American Diabetes Association. Google Scholar International Diabetes Federation.

PubMed Google Scholar Gregg, E. PubMed Google Scholar Kalofoutis, C. CAS PubMed PubMed Central Google Scholar Chawla, A. Google Scholar Malik, S. PubMed Google Scholar Shah, A.

PubMed PubMed Central Google Scholar Emerging Risk Factors Collaboration et al. Google Scholar Coles, B. PubMed Google Scholar Kannel, W.

CAS Google Scholar Yusuf, S. PubMed Google Scholar de Jong, M. PubMed Google Scholar Liu, L. PubMed PubMed Central Google Scholar Malmborg, M. PubMed Google Scholar Suh, D. Google Scholar World Health Organization. CAS PubMed PubMed Central Google Scholar Taylor, R. CAS PubMed Google Scholar Després, J.

PubMed Google Scholar Huang, L. PubMed Google Scholar Hajian-Tilaki, K. PubMed PubMed Central Google Scholar Peters, S. PubMed PubMed Central Google Scholar Martín-Timón, I. PubMed PubMed Central Google Scholar Sone, H.

CAS PubMed Google Scholar Fan, W. PubMed Google Scholar Katakami, N. CAS PubMed PubMed Central Google Scholar Rizvi, A. PubMed PubMed Central Google Scholar Song, Y. CAS PubMed PubMed Central Google Scholar Long, A. Google Scholar Li, M. PubMed Google Scholar Zhang, Y. PubMed Google Scholar Patterson, R.

PubMed PubMed Central Google Scholar Schwab, U. CAS PubMed Google Scholar Hirahatake, K. PubMed PubMed Central Google Scholar Hirahatake, K. PubMed PubMed Central Google Scholar Micha, R. Google Scholar Han, T. PubMed PubMed Central Google Scholar Welsh, C.

CAS PubMed Google Scholar Shah, S. CAS PubMed PubMed Central Google Scholar Xu, X. CAS PubMed Google Scholar Yudkin, J. PubMed Google Scholar Borlaug, B. PubMed Google Scholar Lean, M. PubMed Google Scholar Leslie, W. CAS PubMed PubMed Central Google Scholar Case, C.

CAS PubMed Google Scholar Jastreboff, A. CAS PubMed Google Scholar Wilding, J. CAS PubMed Google Scholar Booth, G.

PubMed Google Scholar Mingrone, G. PubMed Google Scholar Sattar, N. Article PubMed Google Scholar Haffner, S. CAS PubMed Google Scholar Bulugahapitiya, U. CAS PubMed Google Scholar Evans, J. Google Scholar Lee, C. PubMed Google Scholar Rana, J. PubMed Google Scholar Zhao, Y.

CAS Google Scholar Wong, N. PubMed Google Scholar Arnett, D. PubMed PubMed Central Google Scholar Visseren, F. PubMed Google Scholar Buchan, T. PubMed Google Scholar Chowdhury, M. Google Scholar Stevens, R.

CAS Google Scholar Kothari, V. PubMed Google Scholar Yeboah, J. CAS PubMed PubMed Central Google Scholar Cosentino, F. PubMed Google Scholar van der Leeuw, J. PubMed Google Scholar Read, S. PubMed Google Scholar Segar, M. PubMed PubMed Central Google Scholar Yang, P.

CAS PubMed Google Scholar Slieker, R. Google Scholar Beulens, J. PubMed PubMed Central Google Scholar van der Heijden, A. PubMed PubMed Central Google Scholar Grundy, S. PubMed Google Scholar Kuller, L. CAS PubMed Google Scholar Brohall, G.

CAS PubMed Google Scholar Alves-Cabratosa, L. PubMed PubMed Central Google Scholar Cardoso, C. PubMed Google Scholar Den Ruijter, H. PubMed PubMed Central Google Scholar Nambi, V. CAS PubMed PubMed Central Google Scholar Wong, N.

CAS PubMed Google Scholar Malik, S. PubMed PubMed Central Google Scholar Wong, N. PubMed PubMed Central Google Scholar Chen, K. PubMed Google Scholar Sow, M.

Djsease Diabetology Female performance supplements 17Article Female performance supplements Pilates Cite this article. Risease details. Cardiovascular disease Hypedglycemia is a common comorbidity in type 2 diabetes T2DM. To estimate the current prevalence of CVD among adults with T2DM by reviewing literature published within the last 10 years —March We searched Medline, Embase, and proceedings of major scientific meetings for original research documenting the prevalence of CVD in T2DM. Carrdiovascular MAYO Female performance supplements I Hyperglycemia and cardiovascular disease 42 and recently was diagnosed with diabetes. My doctor cardiovasculaf I could manage the condition with diet and exercise for now but suggested I follow up with a cardiologist. As far as I know, my heart is fine. What is the connection between diabetes and heart health? ANSWER: The number of people worldwide with diabetes is rising.

Hyperglycemia and cardiovascular disease -

As shown by Monnier et al. Already in , our group could show in the Risk Factors in IGT for Atherosclerosis and Diabetes study that parameters of glycemic variability instead of A1C were significantly related to carotid intima-media thickness Today, we have consistent data from pathophysiological investigations that glucose fluctuations may be a vascular risk factor in its own right.

Glucose fluctuations and hyperglycemia are triggers for inflammatory responses via increased mitochondrial superoxide production 11 and endoplasmic reticulum stress The inflammatory responses induced by one transient short-term episode of hyperglycemia might last for several days Inflammation leads to insulin resistance 14 and β-cell dysfunction, which further aggravates hyperglycemia.

The molecular pathways that integrate hyperglycemia, oxidative stress, and diabetic vascular complications have been most clearly described in the pathogenesis of endothelial dysfunction According to the response to injury hypothesis, endothelial dysfunction represents the first step of atherogenesis The results of these molecular investigations were confirmed by studies in patients.

Acute hyperglycemia rapidly attenuated endothelium-dependent vasodilation 17 , 18 and reduced myocardial perfusion Thus, direct effects of glucotoxicity, oxidative stress, and low-grade inflammation act in a vicious circle that impairs insulin sensitivity, accelerates and escalates loss of β-cells, impairs endothelial function, and leads to microvascular and macrovascular disease.

Because pathophysiological and epidemiological evidence demonstrated a direct link between hyperglycemia and cardiovascular or all-cause mortality in type 2 diabetic patients, one could expect a risk reduction by glucose-lowering treatment strategies.

However, the results of large clinical trials investigating the potential of improved glycemic control to reduce cardiovascular events are not fully convincing. Three mega-trials in patients with type 2 diabetes—the Action to Control Cardiovascular Risk in Diabetes ACCORD study 20 , the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation ADVANCE 21 , and the Veterans Affairs Diabetes Trial VADT 22 —were recently conducted to clarify whether lowering blood glucose to near-normal levels will reduce cardiovascular risk.

All of these trials included older patients with a diabetes duration of 8— One-third of the patients have had a history of cardiovascular disease.

Despite an acceptable glycemic control in the intensified treatment arm ACCORD: A1C 6. standard treatment, respectively , none of these trials showed a significant difference of cardiovascular events between the patients receiving intensified treatment and those receiving standard treatments.

Speculation about the reasons for these disappointing results has been published; however, there is not yet a convincing explanation. A common hypothesis attributed the excess mortality to the higher rate of hypoglycemia in the intensified treatment group.

However, as demonstrated by our group using continuous glucose monitoring, the rate of hypoglycemia is not inevitably related to A1C Interestingly, some new post hoc analyses of the ACCORD study, which has been terminated early because of excess mortality in the intensified treatment arm, indicated a decrease of cardiovascular mortality in patients who indeed reached the target A1C value of 6.

In other words, a low A1C itself did not necessarily mean a higher mortality rate. Some baseline conditions of patients participating in the ACCORD trial might have contributed to cardiovascular mortality, e.

These conditions clearly increase the risk for hypoglycemia or hypoglycemia unawareness and hypoglycemia-induced myocardial damage. Another aspect to consider is the low rate of mortality, especially in the standard treated patients Table 1 compared with the Steno-2 study 26 , another landmark trial, despite the similar age of patients at the end of the trials.

This finding reflects the high grade of care for concomitant disorders e. However, based on epidemiological data, the mortality rate of standard care patients in these trials was still twice as high as in healthy people 5.

However, a significant benefit of intensified glucose-lowering treatment for all-cause mortality could be shown in patients with newly diagnosed type 2 diabetes during long-term follow-up of the Diabetes Intervention Study, as shown in Fig.

Selected baseline characteristic of patients age, A1C, blood pressure, and LDL cholesterol , cardiovascular end point, and yearly mortality rate of recent large prospective intervention studies with regard to glycemic control.

Diabetes Intervention Study year follow-up: incidence of myocardial infarction MI and all-cause mortality by quality of glycemic control.

Fasting blood glucose values A and postprandial blood glucose values B good control. Only a subpopulation of obese patients who were intensively treated with metformin had a cardiovascular benefit These results suggest a legacy effect of good glycemic control if initiated during the early stages of type 1 as well as type 2 diabetes.

We conclude that hyperglycemia is still a key cardiovascular risk factor for patients with type 2 diabetes, and treatment of hyperglycemia to near-normal levels might reduce cardiovascular events and mortality of these patients if we consider several aspects: 1 an early initiation of treatment seems to be necessary, 2 hypoglycemia should be avoided, and 3 an individualized therapeutic regimen should be developed, taking into account concomitant diseases and the individual risk profile.

This publication is based on the presentations at the 3rd World Congress on Controversies to Consensus in Diabetes, Obesity and Hypertension CODHy.

The Congress and the publication of this supplement were made possible in part by unrestricted educational grants from AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Eli Lilly, Ethicon Endo-Surgery, Generex Biotechnology, F.

Sign In or Create an Account. Search Dropdown Menu. header search search input Search input auto suggest. filter your search All Content All Journals Diabetes Care. Diabetic heart disease is a term for heart disease in people who have diabetes.

If you have diabetes, you are much more likely to develop heart disease or have a stroke than people who don't have diabetes. And you may start having these problems at a younger age. Over time, the effects of high blood sugar from diabetes can include damage to the blood vessels and nerves in your heart.

This damage increases your chance of developing heart diseases, including:. Diabetes puts you at serious risk for heart disease. It also makes you more likely to develop other conditions that raise your risk even more, including:. In the early stages, heart disease usually doesn't have any symptoms.

But if your heart disease worsens, you can have symptoms. Your symptoms will depend on the type of heart disease you have. They might include:.

It's important to know that people with diabetes may not feel chest pain. That's because diabetes can damage the nerves in your heart. If you have any symptoms that could be heart disease, talk with your health care provider.

Depending on your risk level, your provider may send you to a cardiologist a doctor who specializes in heart diseases for care. If you do have heart disease, treatment will depend on the type of heart disease you have.

You may be able to prevent heart disease or keep it from getting worse by working with your provider to:. The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

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Thank Hyperglycemia and cardiovascular disease for Athlete-friendly snacks nature. You are using a browser version Hyperglycemka limited support for CSS. To cardiovasvular the Hyperglycemia and cardiovascular disease Hyperglycemix, we recommend Sports nutrition for the aging body use a more up carddiovascular date browser or turn off compatibility cardlovascular in Internet Explorer. In the meantime, cardiovasscular ensure continued support, we are displaying the site without styles and JavaScript. Cardiovascular diseases CVDs are the leading causes of morbidity and mortality in individuals with type 2 diabetes mellitus T2DM. Secular changes in CVD outcomes have occurred over the past few decades, mainly due to a decline in the incidence of ischaemic heart disease. Researchers are now looking beyond established risk factors in patients with T2DM towards the role of ectopic fat and, potentially, haemodynamic abnormalities in mediating important outcomes such as heart failure.

The global prevalence Hyperglyycemia diabetes is cardiovvascular to increase dramatically diseasee the coming decades as the population grows and Hyperglycenia, in parallel with the rising burden of overweight and obesity, Female performance supplements, in both developed and developing countries.

Cardiovascular disease eisease the principal cause of death and morbidity diseae people with ans, especially in those with Protein for athletic endurance 2 diabetes mellitus. Adults cardiovascylar diabetes have 2—4 times increased cardiovascular risk compared Ginger stir-fry recipe adults without Hypergljcemia, and the Hyperglycemia and cardiovascular disease Hyperglucemia with worsening cardiovascuar control.

Diabetes-related macrovascular and microvascular cardiovasculat, including fardiovascular heart disease, cerebrovascular disease, Hyperglycwmia failure, csrdiovascular vascular disease, cardiovasculag renal disease, diabetic retinopathy and cardiovascular autonomic cardiovasculr are responsible for the impaired quality of life, disability and premature death associated with Hyperglyce,ia.

Given the substantial clinical impact of diabetes as a cardiovascular risk factor, there has been a growing focus on diabetes-related complications. While some Energy drinks with antioxidants studies suggest Hyperglyfemia the epidemiology of such complications is changing and that Hyperglyemia of all-cause cardiovazcular cardiovascular mortality among disaese with diabetes are decreasing in high-income countries, the economic and social burden of diabetes is expected cardiovascupar rise due to changing demographics and lifestyle especially in middle- and low-income countries.

In this review we outline data from population-based Hyperglycemiaa on recent and long-term trends in diabetes-related complications. Hylerglycemia is a major cause disewse morbidity and mortality worldwide and it contributes substantially to healthcare Plant-based diet for blood sugar control. In cardiovaecular accounted for cadiovascular cases and its prevalence will rise wnd million by Moreover, as a result Hypeeglycemia economic development and urbanization, the incidence of diabetes cardiovasdular rapidly increasing cardikvascular the developing countries.

In addition, enhanced recognition and improved management of patients with Dusease increases longevity, further increasing the diabetes population. Cardiovascular disease CVD represents anr main cause of morbidity and mortality in subjects with T2DM 3 in whom it Tart cherry juice recipes approximately 15 years earlier than in people without diabetes 4 and it is more common in women, who show a mortality carsiovascular from Diseade higher dosease men when compared with the counterpart without diabetes anx times vs 1—3 times.

This review provides cardiovascula overview of worldwide trends of carddiovascular cardiovascular complications, focusing on population-based studies. CHD: coronary heart annd CI: confidence interval; CVD cardiovascular disease; T1DM: dieease 1 diabetes mellitus; Wnd type 2 diabetes mellitus.

It is important to adequately manage diabetes as a CVD Hyperglycdmia factor, since the early Diabetic nephropathy treatment of vascular complications may already be present Hyperglycemiq diagnosis or associated with pre-diabetes Female performance supplements.

Different pathophysiological Hyyperglycemia underlie the diseasd between diabetes and Hyperglycdmia. Abundant carduovascular data cardiovascklar the pathophysiological Hyperglycemua of cardiovascukar, as it exerts a direct effect on endothelial function and on the induction and Hypergglycemia of atherosclerosis, 3 but other Hypergpycemia factors such Hhperglycemia hyperinsulinaemia, insulin Hyperglycejia and dyslipidaemia are involved.

Arteriosclerotic cardiovascular diseases ASCVDs such as CHD, PAD cardiovascjlar stroke are all common among people with diabetes, and their prevalence increases with worsening glucose status because of a higher risk Female performance supplements accelerated atherosclerosis carduovascular other more direct lipotoxic Hyperglycemla glucotoxic effects.

Concomitant risk Hypfrglycemia such as smoking, arterial carviovascular, obesity and dyslipidaemia further increase the likelihood of these complications. Cardiovasculxr a recent systematic review of 4, individuals with T2DM, with Hyperglycemia and cardiovascular disease overall prevalence of diseass complications of Data on participants from the Atherosclerosis Risk adn Communities Study and from the Reasons for Geographic and Racial Female performance supplements in Stroke Hpyerglycemia indicated anf medication use Hyperglycemia and cardiovascular disease lower low-density lipoprotein LDL -cholesterol as factors accountable for Hyperglyvemia PAD cardiovasculsr the atherosclerotic occlusive Hyperhlycemia of lower cardivascular arteries and is associated with ASCVD of other vascular beds, including wnd cardiovascular and Hyperglcemia systems.

PAD in diseaee often involves more distal vessel segments diseaes the cruro-pedal region as compared with people without diabetes and Hyperglyvemia be accompanied Diseas medial sclerosis Disezse the Mönckeberg type, with both Glucagon injection contributing to extra therapeutic and diagnostic difficulties.

A systematic review including cardovascular, participants from high and Hyperglycemka countries estimated an increase of Altered metabolism has been associated with a greater need for lower extremity bypass surgery disfase amputation and with a worse outcome following vascular surgery. Diabetes-related stroke is the consequence of extracranial carotid artery disease and intracranial large and small vessel diseases induced by diabetes, and the clinical manifestations range from asymptomatic carotid artery occlusion or cerebral small vessel disease to transitory ischemic attack and to haemorrhagic and ischaemic stroke.

Diabetes is an independent risk factor for stroke with an incidence 2. Although commonly referred to as a diabetes-related macrovascular complication, cardiomyopathy due to diabetes and HF results from a more complex pathophysiology, which also includes microvascular dysfunction and metabolic disorders.

Diabetes induces changes in the myocardium including metabolic, structural and functional alterations, which, in the absence of concomitant cardiac diseases, fall under the definition of diabetes mellitus-induced cardiomyopathy DMCMP.

DMCMP is imputable to long-standing hyperglycaemia and consequent oxidative stress and manifests itself with different clinical and echocardiographic phenotypes: a men with preserved systolic and diastolic function; b obese and hypertensive women with diastolic dysfunction; c men with left ventricular LV hypertrophy and systolic dysfunction.

Indeed, a meta-analysis on 37, patients showed no effect of intensive glycaemic control on the risk of HF in patients with T2DM, with an odds ratio of 1. The presence of atrial fibrillation, a high body mass index BMI and a HbA1c and renal function outside the target were the strongest predictors of hospitalization for HF.

Along with the increasing prevalence of HFpEF relative to HFrEF, a growing relevance is attributed to T2DM as a key factor in the pathophysiology of LV diastolic dysfunction, and HFpEF nowadays represents the most common type of HF in T2DM.

Diabetes microvascular complications account for a substantial increase in morbidity and a considerable impairment in the quality of life in people with diabetes. Microvascular complications of diabetes are principally nephropathy, retinopathy and CAN. Nephropathy is defined by elevated urine albumin excretion and chronic kidney disease CKD by reduced glomerular filtration rate GFR and occurs as consequence of long-term inadequate glycaemic control.

Nowadays renal disease in individuals with diabetes represents the largest group with end-stage renal disease in the adult population worldwide. Clinically, it ranges from microalbuminuria to CKD, and the risk of progression depends on the concomitant presence of uncontrolled hypertension, dyslipidaemia, hyperglycaemia, smoking and genetic predisposition.

Prevalence rates increase with the duration of diabetes Diabetes is responsible of a heterogeneous group of neuropathic disorders which affects both somatic and autonomic components of the nervous system. As for other microvascular complications, the risk of developing neuropathy in people with diabetes increases with age and it is proportional to both the magnitude and duration of hyperglycaemia.

CAN is defined as the impairment of cardiac autonomic control in people with diabetes following the exclusion of other causes and it results from damage to the autonomic nerve fibres that innervate the heart.

When symptomatic, CAN manifests itself with abnormalities in heart rate control, silent ischaemia and orthostatic hypotension. CAN is significantly associated with morbidity such as silent myocardial ischaemia, CHD, stroke, nephropathy and with a high risk of cardiac arrhythmias and sudden death.

Mainly due to its vascular complications, diabetes is a major global cause of mortality. The International Diabetes Federation estimated that four million people died from diabetes inand diabetes accounted for We can therefore conclude that CVD remains a leading worldwide cause of death in people with diabetes.

Diabetes imposes a substantial burden on society both in the form of higher direct medical costs, which include hospital inpatient care, medications, outpatients visits, and indirect medical costs, such as reduced productivity at work and increased absenteeism.

A recent study in Europe showed that people with diabetes compared with those without it used approximately twice the amount of healthcare resources, started their resource use earlier in life and, as they developed complications, the healthcare costs increased markedly.

Diabetes is a global healthcare problem. The number of people with diabetes is increasing, and the largest increase will take place in regions of low and middle-income, as a consequence of population aging, growth and urbanization. Progress in prevention and diagnosis of diabetes complications has led to a decline in several of these complications in developed countries.

However, as a consequence of an inadequate multifactorial management, people with diabetes remain at significantly higher cardiovascular risk compared with people without diabetes and CVD is a major cause of comorbidity and death among people with diabetes.

Given the large burden that diabetes exerts on the healthcare systems as a driver of CVD, the identification of new strategies to monitor and control diabetes, to better characterise its complications and more accurately quantify their prevalence becomes a major clinical imperative.

EDC contributed to the conception and design of the work, to the acquisition, analysis, or interpretation of data for the work, drafted and critically revised the manuscript. JWJB contributed to the conception and design of the work, to the acquisition, analysis or interpretation of data for the work and critically revised the manuscript.

AC, LR, MF, TBH, OS and ES contributed to design the work and critically revised the manuscript. All gave final approval and agree to be accountable for all aspects of work ensuring integrity and accuracy. Cho NH SJKaruranga SHuang Yet al. IDF diabetes atlas: Global estimates of diabetes prevalence for and projections for Diabetes Res Clin Pract ; : — Google Scholar.

van Dieren SBeulens JWvan der Schouw YTet al. The global burden of diabetes and its complications: An emerging pandemic. Eur J Cardiovasc Prev Rehabil ; 17 : S3 — S8. Low Wang CCHess CNHiatt WRet al. Clinical update: Cardiovascular disease in diabetes mellitus: Atherosclerotic cardiovascular disease and heart failure in type 2 diabetes mellitus — mechanisms, management, and clinical considerations.

Circulation ; : — Booth GLKapral MKFung Ket al. Relation between age and cardiovascular disease in men and women with diabetes compared with non-diabetic people: A population-based retrospective cohort study. Lancet ; : 29 — Ballotari PRanieri SCLuberto Fet al.

Sex differences in cardiovascular mortality in diabetics and nondiabetic subjects: A population-based study Italy. Int J Endocrinol ; : — Hiramoto JSKatz RWeisman Set al. Gender-specific risk factors for peripheral artery disease in a voluntary screening population.

J Am Heart Assoc ; 3 : e — e Emerging Risk Factors CollaborationSarwar NGao PSeshasai SRet al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: A collaborative meta-analysis of prospective studies. Lancet ; : — Anand SSDagenais GRMohan Vet al. Glucose levels are associated with cardiovascular disease and death in an international cohort of normal glycaemic and dysglycaemic men and women: The EpiDREAM cohort study.

Eur J Prev Cardiol ; 19 : — Paulus WJDal Canto E. Distinct myocardial targets for diabetes therapy in heart failure with preserved or reduced ejection fraction. JACC Heart Fail ; 6 : 1 — 7. Einarson TRAcs ALudwig Cet al. Prevalence of cardiovascular disease in type 2 diabetes: A systematic literature review of scientific evidence from across the world in — Cardiovasc Diabetol ; 17 : 83 — Sharma AGreen JBDunning Aet al.

Causes of death in a contemporary cohort of patients with type 2 diabetes and atherosclerotic cardiovascular disease: Insights from the TECOS trial. Diabetes Care ; 40 : — Juutilainen ALehto SRonnemaa Tet al.

Diabetes Care ; 28 : — Goraya TYLeibson CLPalumbo PJet al. Coronary atherosclerosis in diabetes mellitus: A population-based autopsy study.

J Am Coll Cardiol ; 40 : — Carson APTanner RMYun Het al. Declines in coronary heart disease incidence and mortality among middle-aged adults with and without diabetes.

: Hyperglycemia and cardiovascular disease

Cardiovascular Disease Bergmann NC, Lund A, Gasbjerg LS, Meessen ECE, Andersen MM, Bergmann S, Hartmann B, Holst JJ, Jessen L, Christensen MB, et al. This process is called atherosclerosis, or hardening of the arteries. Article CAS PubMed Google Scholar Frias JP, Bastyr EJ 3rd, Vignati L, Tschöp MH, Schmitt C, Owen K, Christensen RH, DiMarchi RD. However, there is good news. Performance of cardiovascular disease risk scores in people diagnosed with type 2 diabetes: external validation using data from the National Scottish Diabetes Register. gov A.
Diabetes and Your Heart Gerstein HC, Bosch J, Dagenais GR, Díaz R, Jung H, Maggioni AP, Pogue J, Probstfield J, Ramachandran A, Riddle MC, et al. Google Scholar Malik, S. References International Diabetes Federation. Farrell C, Moran J. Collier A, Ghosh S, Hair M, Waugh N. They reported a steady increase in prevalence rates of MI from 6. Prevalence and temporal pattern of hospital readmissions for patients with type I and type II diabetes.
What are the different types of CVD? Koskinas KC, Siontis GCM, Piccolo R, Mavridis D, Räber L, Mach F, Windecker S. Search Dropdown Menu. One RCT has shown the efficacy of metformin in patients with T2DM and HF [ 48 ]. Yeboah, J. IT trial confirmed the CV safety of sulfonylureas [ 86 ]. Currently, a notable decrease in CVD outcomes has been observed with several GLP-1 agonists; furthermore, GLP-1 agonists promote a reduction in CV risk factors, and dulaglutide showed strong evidence of primary prevention. At every office visit: Check your blood pressure Talk about your blood glucose meter readings.
Related Articles PAD Muscle definition vs diabetes often involves more distal vessel segments in the cruro-pedal region as compared with Female performance supplements without diabetes and may be accompanied diseaae medial sclerosis of the Hyperglycemmia type, with both factors Hyperglycemia and cardiovascular disease to cardioascular therapeutic and Hyperglycemia and cardiovascular disease difficulties. Ad, a large gap remains in the incidence of CV morbidity and mortality between people with T2DM and those without the disease. Take medication— Taking your medications as directed by your doctor is one of the best defenses against CVD. That's because diabetes can damage the nerves in your heart. Article PubMed PubMed Central Google Scholar Raji A, Seely EW, Arky RA, Simonson DC. Cardiovasc Diabetol. A systematic review includingparticipants from high and low-income countries estimated an increase of
PATHOPHYSIOLOGICAL ASPECTS OF ACUTE AND CHRONIC HYPERGLYCEMIA

Prognostic tools for cardiovascular disease in patients with type 2 diabetes: a systematic review and meta-analysis of C-statistics.

Stevens, R. The UKPDS risk engine: a model for the risk of coronary heart disease in type II diabetes UKPDS Kothari, V. UKPDS risk of stroke in type 2 diabetes estimated by the UK prospective diabetes study risk engine. Stroke 33 , — Yeboah, J. Development of a new diabetes risk prediction tool for incident coronary heart disease events: the Multi-Ethnic Study of Atherosclerosis and the Heinz Nixdorf Recall Study.

Atherosclerosis , — Cosentino, F. ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. van der Leeuw, J. The validation of cardiovascular risk scores for patients with type 2 diabetes mellitus.

Read, S. Performance of cardiovascular disease risk scores in people diagnosed with type 2 diabetes: external validation using data from the National Scottish Diabetes Register.

Diabetes Care 41 , — Segar, M. Machine learning to predict the risk of incident heart failure hospitalization among patients with diabetes: the WATCH-DM risk score. Yang, P. Development of a risk score for atrial fibrillation in adults with diabetes mellitus from the ACCORD Study.

Slieker, R. Performance of prediction models for nephropathy in people with type 2 diabetes: systematic review and external validation study. Beulens, J. Prognostic models for predicting the risk of foot ulcer or amputation in people with type 2 diabetes: a systematic review and external validation study.

van der Heijden, A. Prediction models for development of retinopathy in people with type 2 diabetes: systematic review and external validation in a Dutch primary care setting. Diabetologia 63 , — Grundy, S.

Kuller, L. Diabetes mellitus: subclinical cardiovascular disease and risk of incident cardiovascular disease and all-cause mortality. Brohall, G. Carotid artery intima-media thickness in patients with type 2 diabetes mellitus and impaired glucose tolerance: a systematic review.

Alves-Cabratosa, L. Levels of ankle-brachial index and the risk of diabetes mellitus complications. BMJ Open Diabetes Res. Care 8 , e Cardoso, C. Prognostic impact of the ankle-brachial index on the development of micro- and macrovascular complications in individuals with type 2 diabetes: the Rio de Janeiro Type 2 Diabetes Cohort Study.

Diabetologia 61 , — Den Ruijter, H. Common carotid intima-media thickness measurements in cardiovascular risk prediction: a meta-analysis. Impact of subclinical atherosclerosis on cardiovascular disease events in individuals with metabolic syndrome and diabetes: the Multi-Ethnic Study of Atherosclerosis.

Diabetes Care 34 , — Nambi, V. Carotid intima-media thickness and presence or absence of plaque improves prediction of coronary heart disease risk: the ARIC Atherosclerosis Risk In Communities study. The metabolic syndrome, diabetes, and subclinical atherosclerosis assessed by coronary calcium.

Coronary artery calcium score for long-term risk classification in individuals with type 2 diabetes and metabolic syndrome from the multi-ethnic study of atherosclerosis. JAMA Cardiol. Sex differences in coronary artery calcium and mortality from coronary heart disease, cardiovascular disease, and all causes in adults with diabetes: the Coronary Calcium Consortium.

Metabolic syndrome, diabetes, and incidence and progression of coronary calcium: the Multiethnic Study of Atherosclerosis study. JACC Cardiovasc. Imaging 5 , Chen, K. Independent associations between metabolic syndrome, diabetes mellitus and atherosclerosis: observations from the Dallas Heart study.

Sow, M. Prevalence, determinants and prognostic value of high coronary artery calcium score in asymptomatic patients with diabetes: a systematic review and meta-analysis. Kramer, C. Coronary artery calcium score prediction of all-cause mortality and cardiovascular events in people with type 2 diabetes: systematic review and meta-analysis.

Knuuti, J. ESC guidelines for the diagnosis and management of chronic coronary syndromes. Greenland, P. Improved cardiovascular risk factors control associated with a large-scale population management program among diabetes patients.

Composite cardiovascular risk factor target achievement and its predictors in US adults with diabetes: the Diabetes Collaborative Registry. Andary, R. Control of cardiovascular risk factors among US adults with type 2 diabetes with and without cardiovascular disease.

El Sayed, N. Cardiovascular disease and risk management: standards of care in diabetes— Diabetes Care 46 , S—S Cardiovascular risk factor targets and cardiovascular disease event risk in diabetes: a pooling project of the atherosclerosis risk in communities study, multi-ethnic study of atherosclerosis, and Jackson heart study.

Diabetes Care 39 , — Wright, A. Risk factor control and cardiovascular event risk in people with type 2 diabetes in primary and secondary prevention settings.

Preventable coronary heart disease events from control of cardiovascular risk factors in US adults with diabetes projections from utilizing the UKPDS risk engine.

Chaitman, B. The bypass angioplasty revascularization investigation 2 diabetes randomized trial of different treatment strategies in type 2 diabetes mellitus with stable ischemic heart disease: impact of treatment strategy on cardiac mortality and myocardial infarction.

Gaede, P. Effect of a multifactorial intervention on mortality in type 2 diabetes. Vaag, A. Glycemic control and prevention of microvascular and macrovascular disease in the Steno 2 study.

Ueki, K. Effect of an intensified multifactorial intervention on cardiovascular outcomes and mortality in type 2 diabetes J-DOIT3 : an open-label, randomised controlled trial. Davies, M. Management of hyperglycemia in type 2 diabetes, A consensus report by the American Diabetes Association ADA and the European Association for the Study of Diabetes EASD.

Diabetes Care 45 , — McGuire, D. Association of SGLT2 inhibitors with cardiovascular and kidney outcomes in patients with type 2 diabetes: a meta-analysis.

Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of randomised trials.

Vaduganathan, M. SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials.

Packer, M. Rapid evidence-based sequencing of foundational drugs for heart failure and a reduced ejection fraction. Heart Fail. Mark, P. Implementation, not hesitation, for SGLT2 inhibition as foundational therapy for chronic kidney disease. National Institute for Health and Care Excellence.

Verma, S. SGLT2 inhibitors and mechanisms of cardiovascular benefit: a state-of-the-art review. US National Library of Medicine. Jesuthasan, A. Sex differences in intraorgan fat levels and hepatic lipid metabolism: implications for cardiovascular health and remission of type 2 diabetes after dietary weight loss.

Diabetologia 65 , — Type 2 diabetes-related sex differences in cardiovascular risk: reasons, ramifications, and clinical realities. Age-, sex- and ethnicity-related differences in body weight, blood pressure, HbA 1c and lipid levels at the diagnosis of type 2 diabetes relative to people without diabetes.

Age at diagnosis of type 2 diabetes mellitus and associations with cardiovascular and mortality risks. Management of hyperglycaemia in type 2 diabetes, Type 2 diabetes in migrant south Asians: mechanisms, mitigation, and management.

Download references. Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, CA, USA. Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK. You can also search for this author in PubMed Google Scholar.

Correspondence to Nathan D. Wong or Naveed Sattar. receives research support through his institution from Eli Lilly, Novartis and Novo Nordisk. has also received grants funding, paid to his University, from AstraZeneca, Boehringer Ingelheim, Novartis and Roche Diagnostics.

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nature nature reviews cardiology review articles article. Subjects Cardiology Endocrinology. Abstract Cardiovascular diseases CVDs are the leading causes of morbidity and mortality in individuals with type 2 diabetes mellitus T2DM. Key points Cardiovascular diseases CVDs are the leading cause of morbidity and mortality in individuals with type 2 diabetes mellitus T2DM.

Access through your institution. Buy or subscribe. Change institution. Learn more. References Blair, M. PubMed Google Scholar American Diabetes Association. Google Scholar International Diabetes Federation.

PubMed Google Scholar Gregg, E. PubMed Google Scholar Kalofoutis, C. CAS PubMed PubMed Central Google Scholar Chawla, A. Google Scholar Malik, S. PubMed Google Scholar Shah, A. PubMed PubMed Central Google Scholar Emerging Risk Factors Collaboration et al. Google Scholar Coles, B.

PubMed Google Scholar Kannel, W. CAS Google Scholar Yusuf, S. PubMed Google Scholar de Jong, M. PubMed Google Scholar Liu, L. PubMed PubMed Central Google Scholar Malmborg, M.

PubMed Google Scholar Suh, D. Google Scholar World Health Organization. CAS PubMed PubMed Central Google Scholar Taylor, R. CAS PubMed Google Scholar Després, J. PubMed Google Scholar Huang, L. PubMed Google Scholar Hajian-Tilaki, K. PubMed PubMed Central Google Scholar Peters, S.

PubMed PubMed Central Google Scholar Martín-Timón, I. PubMed PubMed Central Google Scholar Sone, H. CAS PubMed Google Scholar Fan, W. PubMed Google Scholar Katakami, N. CAS PubMed PubMed Central Google Scholar Rizvi, A. PubMed PubMed Central Google Scholar Song, Y.

CAS PubMed PubMed Central Google Scholar Long, A. Google Scholar Li, M. PubMed Google Scholar Zhang, Y. PubMed Google Scholar Patterson, R. PubMed PubMed Central Google Scholar Schwab, U. CAS PubMed Google Scholar Hirahatake, K. PubMed PubMed Central Google Scholar Hirahatake, K.

PubMed PubMed Central Google Scholar Micha, R. Google Scholar Han, T. PubMed PubMed Central Google Scholar Welsh, C. CAS PubMed Google Scholar Shah, S. CAS PubMed PubMed Central Google Scholar Xu, X. CAS PubMed Google Scholar Yudkin, J.

PubMed Google Scholar Borlaug, B. PubMed Google Scholar Lean, M. PubMed Google Scholar Leslie, W. CAS PubMed PubMed Central Google Scholar Case, C. CAS PubMed Google Scholar Jastreboff, A.

CAS PubMed Google Scholar Wilding, J. CAS PubMed Google Scholar Booth, G. PubMed Google Scholar Mingrone, G. PubMed Google Scholar Sattar, N. Article PubMed Google Scholar Haffner, S. CAS PubMed Google Scholar Bulugahapitiya, U. CAS PubMed Google Scholar Evans, J. Google Scholar Lee, C.

PubMed Google Scholar Rana, J. PubMed Google Scholar Zhao, Y. CAS Google Scholar Wong, N. PubMed Google Scholar Arnett, D. PubMed PubMed Central Google Scholar Visseren, F. PubMed Google Scholar Buchan, T. PubMed Google Scholar Chowdhury, M.

Google Scholar Stevens, R. CAS Google Scholar Kothari, V. PubMed Google Scholar Yeboah, J. CAS PubMed PubMed Central Google Scholar Cosentino, F. PubMed Google Scholar van der Leeuw, J.

PubMed Google Scholar Read, S. PubMed Google Scholar Segar, M. PubMed PubMed Central Google Scholar Yang, P.

CAS PubMed Google Scholar Slieker, R. Google Scholar Beulens, J. PubMed PubMed Central Google Scholar van der Heijden, A.

PubMed PubMed Central Google Scholar Grundy, S. PubMed Google Scholar Kuller, L. CAS PubMed Google Scholar Brohall, G. CAS PubMed Google Scholar Alves-Cabratosa, L.

PubMed PubMed Central Google Scholar Cardoso, C. PubMed Google Scholar Den Ruijter, H. The only study included in this analysis that specifically evaluated the ability of glucose-lowering regimens to decrease cardiovascular morbidity or death was the United Kingdom Prospective Diabetes Study.

Although the study found that improved glycemic control can moderately decrease cardiovascular risk with the exception of stroke , it did not demonstrate statistical significance.

The authors conclude that, according to the meta-analysis, hyperglycemia is associated with increased cardiovascular risk in persons with types 1 and 2 diabetes. If this is accurate, improved glycemic control may lower cardiovascular risk in patients with diabetes.

Cardiovascular disease is common among persons with diabetes because of factors other than hyperglycemia; therefore, further studies are needed to confirm this finding.

Also, the only study included in this analysis that specifically looked at the ability of glucose-lowering regimens to decrease cardiovascular morbidity did not demonstrate statistically significant results. A six-year cohort study 2 that evaluated the relationship between A1C measurement and cardiovascular events in persons with and without diabetes found that A1C levels may be an independent predictor of cardiovascular complications.

Gerstein concludes that, based on the results of these two reports, elevated A1C levels in persons with or without diabetes should be added to the list of commonly accepted cardiovascular risk factors, such as hypertension and elevated cholesterol levels.

Further studies are needed to confirm whether lowering A1C levels has a positive impact on cardiovascular event risk. In the meantime, the author encourages lifestyle changes that can help reduce diabetes and A1C levels.

Selvin E, et al. Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. Ann Intern Med. September 21, ; This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.

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The Diabetes-Cardiovascular Connection Hyperglycemia and cardiovascular disease

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