Risk factors, mortality, and cardiovascular outcomes in patients with type 2 diabetes

In search of clues to mitigate the excess risk of death and cardiovascular (CV) events among type 2 diabetics, researchers studied a large cohort of patients and controls in Sweden.

In search of clues to mitigate the excess risk of death and cardiovascular (CV) events among type 2 diabetics, researchers studied a large cohort of patients and controls in Sweden. Of particular interest was the impact of five risk factors: elevated glycated hemoglobin level, elevated low-density lipoprotein cholesterol level, albuminuria, smoking, and high blood pressure. The study pool included more than 271,000 individuals with type 2 diabetes and more than 1.3 million nondiabetics matched by age, gender, and county. In all, 175,345 deaths were documented during the median follow-up period of 5.7 years. Among patients with diabetes, excess risk for death and CV events decreased stepwise for each risk factor variable that remained on target. For patients who kept all five within range, there evidently was little to no excess risk of mortality, myocardial infarction, or stroke compared with the general population. Individually, however, smoking was the strongest predictor of death; and spiked levels of glycated hemoglobin were predictive of stroke and acute myocardial infarction. All type 2 diabetics, meanwhile, were at greater risk for hospitalization for heart failure compared to controls.