The link between diabetes and an increased risk for cardiovascular disease has long been established, but a new study has now shown that the age at which a person is diagnosed with diabetes could significantly affect the risk of heart attack or stroke.
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The study, which was recently published in the American Heart Association’s journal Circulation, revealed that people who are diagnosed with diabetes when they are under the age of 40 are significantly more likely to develop or die from cardiovascular disease, when compared with people of a similar age who do not have diabetes. The increased age-related risk is particularly pronounced among women, report the authors.
Furthermore, the risk of death among people diagnosed with diabetes at age 80 or older is much the same as for those of a similar age without diabetes.
Our study shows the differences in excess diabetes risk are tied to how old the person is when they are diagnosed with Type 2 diabetes.”
Naveed Sattar, Lead Author (University of Glasgow, UK)
Obesity and type 2 diabetes cases are rising
Over the last four decades, obesity rates have steadily increased in high-income countries, with more adolescents and young people being diagnosed with type 2 diabetes than ever before. The WHO estimates that most of the 422 million people living with diabetes worldwide have type 2 diabetes.
For the study, Sattar and colleagues used data from the Swedish National Diabetes Registry to follow 318,083 individuals with type 2 diabetes and 1,575,108 age-, gender- and county-matched controls between 1998 and 2013.
All participants were assessed for their risk of developing heart disease, stroke, heart attack, atrial fibrillation and being hospitalized due to heart failure. Death as a result of heart disease or any other condition was also evaluated.
Patient's younger than 40 are most at risk
The team reports that participants diagnosed with diabetes before they reached the age of 40 were at the greatest increased risk for one of the five outcomes and were also more likely to have died from cardiovascular disease compared with those of a similar age who did not have diabetes. Women tended to be more affected by the increased risk than men were, across most categories.
The study also revealed that the excess risk for cardiovascular disease or mortality steadily declined with increasing age at diabetes diagnosis. Furthermore, cardiovascular-related death was greatly reduced among people diagnosed with diabetes at age 80 years or older, with their risk being much the same as for individuals of a similar age who did not have diabetes.
Lifestyle changes could delay the onset of diabetes by 'several years'
Sattar says the findings suggest more aggressive control of risk factors is needed among younger people with type 2 diabetes, particularly women. He adds:
Our work could also be used to encourage middle-aged people at elevated diabetes risk to adopt lifestyle changes to delay their diabetes by several years."
The authors note that the study followed a mainly white European population and that further studies examining these associations in non-white populations with type 2 diabetes are required.