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Diabetes - Type 2 Community
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973741 tn?1342346373

Why are Diabetes and Heart Disease So Interrelated?

You see so much of these two things being co concerns.  I was wondering why heart disease and diabetes are so intertwined?  If you have diabetes, do they treat you more aggressively for any cardiovascular concerns?
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Avatar universal
This article addresses the connection between diabetes and cardiovascular disease:
https://www.healthline.com/health/type-2-diabetes/understanding-cv-disease-diabetes
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That article unfortunately does not address the surprising and interesting finding of the famous ACCORD trial concerning the effect of blood glucose. Going from memory: aggressive lowering of HbA1c via meds did not further lower the primary endpoint of cardiac events (including death and Acute Coronary Syndromes); though btw it did result in increased overall mortality.

(The article merely talks about how "Sugar [results in] damage to your blood vessels and the nerves that control them".)

ACCORD did, however, find benefit for microvascular diseases (IIRC, heart failure, & retina and kidney damage).

So ACCORD would seem to say that its really all about the risk factors for heart disease being the same for T2DM, and that explains why they go together.

However, there is this curiosity: "...one medical study found that people with diabetes who had no other health risk factors for heart disease were 5 times more likely to die of heart disease than those without."  
https://www.webmd.com/diabetes/heart-blood-disease

But there is no citation given for that statement, and I didn't find it in a quick look see. Maybe the conclusion is confounded in a way by not distinguishing between micro and macro disease. However, they do go on to say that "Another medical study showed that people with diabetes, no matter the number of other heart disease risk factors, were as likely to have a heart attack as someone without diabetes who has already had a heart attack." So maybe it is the BG, or else maybe hyperinsulinema.

As always, nothing is simple :)

==============

Here's a 2 minute vid entitled "ADA: ACCORD Diabetes Trial a Complete Bust"
https://www.youtube.com/watch?v=ZhFY6LE6nRM
231441 tn?1333896366
COMMUNITY LEADER
Hi

The answer comes in understanding about insulin resistance.  Insulin resistance typically precedes diabetes by many years, maybe even decades.  

High insulin is inflammatory.  This is what contributes to / causes heart disease.

They also know that even slightly elevated blood glucose, still in the "prediabetic range" is associated with heart disease.

How to address insulin resistance?  Lifestyle for sure.  Lower carb, low processed floods, low sugar, exercise, weight management, stress management.
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231441 tn?1333896366
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