Effectiveness of diabetes treatment for coronary heart disease
Prevalence of diabetes mellitus (DM). In the US, 21 million (or 7%) of the population suffers from diabetes, and in 90% of cases it is diabetes. Approximately 30% of patients with diabetes do not know that they are sick. The prevalence of diabetes has increased in the last 10 years, which may be due to an increase in BMI. Another disturbing trend is the increase in diabetes-2 (formerly called adult diabetes) among children; The number of new cases in some areas of the United States is> 30%. If such trends continue, more than 1 in 3 people born in 2000 will have recounted diabetes mellitus during their lifetime.
Associated risk. Diabetes is a powerful FR of atherosclerotic diseases, their complications and cardiovascular death. Among those aged 40 years, KBS is the leading cause of death for men and women suffering from diabetes.
A study of a representative national cohort of adult patients with diabetes shows that heart disease is indicated in 69% of death certificates. During the 10-year follow-up study of the Health Professionals Follow-Up Study, the relative multifactor risks of fatal ASC were 3.84 (95% CI 3.12-4.71) for those who only had diabetes, 7.88 (95 % CI 6.86-9.05) – for those who had only MI, and 13.41 (95% CI 10.49-17.16) – for those who had both diseases, compared with who at the beginning of the observation had neither SD nor IM.
Similar, although less pronounced associations were observed in women in the Nurses’ Health Study with a follow-up of 20 years. Diabetes in women has a stronger effect on the risk of CHD than in men; women with diabetes have a higher risk of death from coronary heart disease (CHD).
According to the data, the risk of fatal outcome of KBS in persons suffering from diabetes, but not having documented KBS, is as high as in individuals with documented KBS, but without diabetes. However, this fact remains the subject of controversy, with the exception, perhaps, of one study that showed that men with CHD indicates a higher risk of death from CHD than from diabetes, whereas women with diabetes have a higher risk associated with CHD.
Thus, patients with diabetes should be considered as persons with a high risk of CHD, despite the presence or absence of other risk factors; moreover, diabetic patients with well-controlled HbA1C levels have a lower vascular risk than individuals with poor control of this indicator.