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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Tuesday, May 13, 2008
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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Tuesday, May 13, 2008
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Diabetes is one of the most common chronic diseases affecting people in the United States.
The vast majority, 90-95% of cases of diabetes are Type II Diabetes Mellitus, with 5-10% developing Type I Diabetes Mellitus. Currently, nearly 21 million people suffer from diabetes, of which six million adults are undiagnosed. Even more worrisome is the nearly 41 million adults aged 40-74 years old who are considered pre-diabetic. There are 1.5 million new cases of diabetes diagnosed annually.
Diabetes is the leading cause of:
If this were not enough, the association of diabetes and heart disease is a common, but frequently misunderstood and worse yet, poorly treated disorder. Most do not realize that diabetes involves not only elevations on glucose (carbohydrate) levels, but also a metabolic disorder of lipids (fats) and protein metabolism as well, which leads to a significantly increased heart disease risk.
Both Type II and Type I are associated with increased risk of heart disease and heart disease prevention guidelines apply to both types, yet the best approaches and treatments vary a great deal.
In order to successfully decrease complications of Type I Diabetes Mellitus, mere replacement of insulin can be instrumental in mitigating many of the known complications.
Type II, however, is more complex and insulin replacement is often a later therapy employed, if ever. Targets of therapy include:
Most patients with diabetes are unaware of the enhanced clotting nature of their blood as a result of these many metabolic abnormalities. Patients with diabetes have a two to three fold increased prognosis following any heart attack or unstable angina, than non-diabetics who are of similar ethnicity, race, gender, etc.
Studies have indicated that glucose levels are a continuous risk factor for heart disease. In fact, it is estimated that for every 1% increase in hemoglobin in the blood (HbA1C) there is a 10-30% increase of heart disease. A few recent studies have suggested that reducing glucose levels lower risk of heart disease.
In an effort to objectively evaluate the heart disease imposed by diabetes, the National Institutes of Health sponsored the ACCORD Trial (Action to Control Cardiovascular Risk Reduction). It was designed in the late 90's and began in 2001. After the near decade of clinical care, event data collection and different treatment goals, we may finally have greater insight into the diabetes metabolism problems that lead to increased heart disease and the benefits of treatments according to existing guidelines and beyond.
This article is a NetWellness exclusive. 
Last Reviewed: Sep 06, 2006
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Laurie Sadler, MD Medical Director and Assistant Professor Center for Vascular Health St. Vincent Charity Hospital School of Medicine Case Western Reserve University |
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