A recent European study has found that women living with
diabetes are at greater risk of cardiovascular complications with
the trend set to increase in the coming decades.
Cardiovascular disease is more likely to occur earlier in
patients with diabetes. It can be up 15 years earlier and it is
their main cause of morbidity and mortality.
In women, the links between diabetes and cardiovascular disease
are particularly potent.
Globally, there are more deaths due to diabetes in women than in
men (2.1 versus 1.8 million annually) - this excess risk is mainly
due to the higher risk of cardiovascular death in women.
Coronary heart disease is the most frequently reported form of
cardiovascular disease and the most lethal one. Women with diabetes
are at a 1.81-fold risk of death from coronary heart disease
compared to women without diabetes.
Men with diabetes have a 1.48-fold risk of death from coronary
heart disease compared to men without diabetes.
Peripheral artery disease - which can ultimately lead to foot
amputation - is the most common initial manifestation of
cardiovascular disease in patients with type 2 diabetes. Its
prevalence is 1.8-fold higher in women compared to men.
Heart failure is the second most common initial manifestation of
cardiovascular disease in type 2 diabetes.
Women with diabetes are five times more likely to get heart
failure than women without diabetes. Men with diabetes are two
times more likely to get heart failure than men without
diabetes.
Research is ongoing to explain these differences between women
and men.
One possible reason for the higher heart failure risk could be
that a specific form is more common in women generally and is the
type most likely to affect patients with diabetes.
This form is called heart failure with preserved ejection
fraction, where the heart maintains its pump function but has
increased stiffness causing impaired relaxation after
contraction.
In both women and men, a healthy lifestyle is the cornerstone to
preventing diabetes; once people have diabetes, it is fundamental
to stopping the cardiovascular complications.
Senior author Professor Joline Beulens, of Amsterdam University
Medical Centre, the Netherlands said, "With the increased levels of
obesity in our society we have seen an enormous rise in the
prevalence of diabetes. We know that type 2 diabetes can be
prevented or managed with better lifestyle behaviors."
"Lifestyle management is the first line of treatment for
patients with diabetes. If lifestyle doesn't sufficiently control
glucose levels and the risk of complications, then glucose-lowering
treatment should be initiated as the second line of therapy."
Professor Beulens said, "Patients with diabetes remain at
significantly higher cardiovascular risk compared to people without
diabetes. There is an urgent need to better identify, monitor, and
control diabetes to prevent the devastating cardiovascular
complications."