Lowering Blood Glucose Also Lowers heart Disease Risk

Effect of progression from impaired glucose tolerance to diabetes in cardiovascular risk factors and its amelioration by lifestyle and metformin intervention, by Roland B. Goldberg and colleagues. Diabetes Care 32:726–732, 2009

What is the problem and what is known about it so far?

Heart and blood vessel disease causes heart attacks and strokes and is the number one cause of death in people with diabetes. People who have certain risk factors including high blood pressure, blood fat (cholesterol) problems, and pre-diabetes (blood glucose levels higher than normal but not high enough to be diabetes) are more likely to get heart and blood vessel disease. As pre-diabetes gradually worsens to diabetes, a person's blood glucose levels rise. But no one knows how that affects a person's chance of getting heart and blood vessel disease.

Why did the researchers do this particular study?

The researchers wanted to look at the relationship between high blood pressure, cholesterol problems, and rising blood glucose levels and how they affect a person's chances of getting heart and blood vessel disease over time.

Who was studied?

The study included more than 3,200 patients who had participated in the Diabetes Prevention Program (DPP), an earlier study comparing lifestyle changes and medicine for preventing and delaying diabetes.

How was the study done?

The researchers analyzed data about blood pressure, cholesterol, and blood glucose levels during the DPP to see how increasing blood glucose affected the other risk factors for heart and blood vessel disease. They looked at this information for people who made lifestyle changes and people who were treated with metformin.

What did the researchers find?

Patients' chances of getting heart and blood vessel disease increased as their blood glucose levels got higher and decreased as their blood glucose levels fell. Early lifestyle changes, and to a lesser extent metformin treatment, improved both blood glucose levels and the overall risk for heart and blood vessel disease. There was not a big change in risk at the exact point where people with pre-diabetes progressed to diabetes. Instead, the risk increased gradually as blood glucose levels increased.

What are the implications of the study?

For patients with pre-diabetes, taking early steps to lower blood glucose levels will also reduce the likelihood of getting heart and blood vessel disease.

FOR MORE INFORMATION

Preventing Pre-Diabetes

Diabetes, Heart Disease, and Stroke

101 Tips for Improving Blood Glucose