Heart risk falls for diabetes patients

2 minute read

Better diabetes care may be to thank for the drop in heart attacks and strokes.

The risk of heart attack and stroke among people with type 2 diabetes is falling, a Canadian study has found.  

Newer diabetes treatments and better overall care may be to thank for the good news, according to experts.  

The findings reflect Australian diabetes figures from earlier this year that showed rates of hospitalisation for myocardial infarction, heart failure and hypoglycaemia have fallen over time. 

Researchers analysed Canadian health data from five cohorts of adults over almost three decades and found that while people with diabetes were initially at twice the risk of a cardiovascular event, this dropped to an only 50% increased risk in recent years.   

And while the magnitude of the association between diabetes and risk of cardiovascular events decreased, the association between CVD and cardiovascular events remained the same. 

“These results suggest that diabetes is still an important cardiovascular risk factor but no longer equivalent to CVD – a change that likely reflects the use of modern, multifactorial approaches to diabetes,” the authors wrote in their research letter. 

The finding adds to evidence from an Australian study published in Diabetes Care earlier this year that showed hospitalisation rates for myocardial infarction, heart failure and hypoglycaemia fell over the last decade in people with type 2 diabetes.

The study also found that among people with type 1 diabetes, trends in admissions for diabetes-related complications were largely stable. 

However, there was an increase in lower-extremity amputation among people with type 2 diabetes, which the authors noted “was entirely attributable to minor amputations, while the incidence of major amputations was stable”. 

The authors said gaps in healthcare monitoring meant that the reasons for the trend, such as improved risk factor control, could not be determined. 

“However, we have observed an increase in the use of glucagon-like peptide 1 receptor agonists and sodium–glucose cotransporter inhibitors in the current cohort with type 2 diabetes … which may have had an impact on rates of myocardial infarction.  

“Moreover, sodium–glucose cotransporter inhibitors considerably reduce the incidence of heart failure and thus may have contributed to declines in heart failure. However, given that declines in the incidence of myocardial infarction and heart failure predate widespread use of these drugs, it is unlikely that these drugs played a major role in these declines.” 

JAMA Network Open 2022, online 14 October  

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