Diabetes: Even High Risk Patients May Have Modifiable Risk Factors

MedicalResearch.com: Interview with:
Interview with Professor Donald W Bowden and Dr. Amanda J Cox
Center for Diabetes Research,
Center for Genomics and Personalized Medicine Research
Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC

Medical Research: What are the main findings of the study?

Answer: The study examined modifiable cardiovascular disease (CVD) risk factors and risk for mortality in a subset of individuals from the Diabetes Heart Study who were at high risk based for cardiovascular disease based on burden of subclinical CVD assessed by coronary artery calcified plaque scores greater than 1000. Even among this high risk group, known CVD risk factors were still useful in assessing ongoing risk for mortality.  Use of cholesterol-lowering medication was one factor identified to be protective against mortality.

Medical Research: Were any of the findings unexpected?

Answer: It was assumed that risk for mortality would be consistently high among this subgroup given the individual histories (and duration) of type 2 diabetes and the presence of subclinical cardiovascular disease. However, 60% of this high-risk subset were still living after, on average, more than eight years of follow-up supports the potential for variable and modifiable risk, even in the presence of multiple existing risk factors.

Medical Research: What should clinicians and patients take away from your report?

Answer: The findings from this study indicate that even among type 2 diabetes patients identified to be at high risk of adverse outcome, modifiable risk factors exist that should be targeted for early and continued intervention.

Medical Research: What recommendations do you have for future research as a result of this study?

Answer: Identification of multiple modifiable risk factors supports the multifactorial nature of cardiovascular disease and the need for concurrent risk reduction strategies. Future research should aim to further resolve the seemingly episodic events that lead to adverse outcome and which may explain the variable risk noted in this subset.


Contributors to Mortality in High-Risk Diabetic Patients in the Diabetes Heart Study

Diabetes Care published ahead of print July 2, 2014, doi:10.2337/dc14-0081 1935-5548
Amanda J. Cox, Fang-Chi Hsu, Barry I. Freedman, David M. Herrington, Michael H. Criqui, J. Jeffrey Carr, and Donald W. Bowden


Last Updated on July 8, 2014 by Marie Benz MD FAAD