13 Apr Mortality From Cardiovascular Disease in Type 1 and Type 2 Diabetes Drops, But Still Exceeds General Population

MedicalResearch.com Interview with:

Dr. Rawshani

Aidin Rawshani, MD, PhD student
Sahlgrenska Academy
University of Gothenburg

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Management of diabetes has improved in the past decades, studies have shown that mortality and cardiovascular disease among patients with diabetes has decreased, but these studies have not compared the trends among persons with type 1 diabetes and type 2 diabetes to those of the general population, where there have also been reductions in cardiovascular morbidity and mortality.

We observed marked reductions in incidence for cardiovascular disease and mortality among individuals with diabetes, however, similar trends were observed for the general population. We observed a 43% (HR 1.43, 95% CI 1.25–1.62) greater event rate reduction for cardiovascular disease among individuals with type 1 diabetes compared to matched controls. The reduction in the rate of fatal outcomes did not differ significantly between patients with type 1 diabetes and controls, whereas patients with type 2 diabetes had a 13% (HR 0.87, 95% CI 0.85–0.89) lesser event rate reduction compared with matched controls.

There was a 27% (HR 1.27, 95% CI 1.22–1.32) greater event rate reduction for cardiovascular disease among individuals with type 2 diabetes, compared with matched controls. Nevertheless, there remains a substantial excess overall rate of all outcomes analysed among persons with type 1 diabetes and type 2 diabetes, as compared with the general population.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Future research is warranted to determine the underlying causes for the trends character. The study revealed some noteworthy trends that raises a lot of new questions, for example, has the advances in diabetes care preferentially altered atherosclerotic and microvascular disease processes that reduces the risk for non-fatal outcomes, but that other factors that are more directly contributing to fatal events been attenuated to a lesser degree in patients with diabetes.

Nevertheless, there is still an excess overall risk for every outcome analysed for individuals with diabetes, compared with controls, further underpinning the importance of continued research aimed at mitigating the residual cardiovascular risk associated with diabetes, and especially mortality risk.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes
Aidin Rawshani, M.D., Araz Rawshani, M.D., Ph.D., Stefan Franzén, Ph.D., Björn Eliasson, M.D., Ph.D., Ann-Marie Svensson, Ph.D., Mervete Miftaraj, M.Sc., Darren K. McGuire, M.D., M.H.Sc., Naveed Sattar, M.D., Ph.D., Annika Rosengren, M.D., Ph.D., and Soffia Gudbjörnsdottir, M.D., Ph.D.
N Engl J Med 2017; 376:1407-1418
April 13, 2017DOI: 10.1056/NEJMoa1608664

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Last Updated on April 13, 2017 by Marie Benz MD FAAD