No drop in heart disease in diabetics

A new study of local patients with Type I diabetes has found that the rates of heart disease and some other diabetes-related complications did not decline over time.

While a significant drop occurred in mortality, renal failure and neuropathy -- a peripheral nerve disorder caused by diabetes -- no similar decrease was noted in heart disease, early kidney disease or eye disease, according to the study, led by researchers at the University of Pittsburgh Graduate School of Public Health.

The study, to be published Monday in the journal Diabetes, was released early on the journal's Web site.

The findings suggest that "we're not treating Type I diabetes vigorously enough," said Dr. Trevor Orchard, a co-author and professor of epidemiology, medicine and pediatrics.

More than 700,000 Americans have Type I diabetes, an autoimmune disorder in which the body errantly attacks the insulin-producing cells of the pancreas. It is usually diagnosed in children and young adults. Many more people have Type II diabetes, which typically begins in adulthood and usually results from cells in the body becoming resistant to insulin.

While recent studies in Europe have focused on the effects of Type I diabetes, those studies followed patients for shorter periods and did not assess the incidence of heart disease, Dr. Orchard said.

The Pitt study analyzed long-term complications in 906 Type I diabetics who were Children's Hospital patients between 1950 and 1980.

Researchers divided participants into five groups according to the year their diabetes was first diagnosed. They also analyzed life span and illness data among participants for up to 30 years after their diagnoses.

Researchers were "surprised and disappointed" that the rates of heart disease and other complications did not improve when some diabetes-related problems improved dramatically, Dr. Orchard said.

The study suggests that more emphasis should be placed on controlling blood pressure and cholesterol levels in Type I diabetes patients, said Georgia Pambianco, the study's lead author.

Better treatment guidelines for those patients need to be developed, Dr. Orchard said.

He also noted that a recent national trial suggests that significantly lowering blood sugar levels is associated with reduced risk of heart disease.

In the past, similar reductions were not seen in patients participating in the Pitt study, he said.

Other co-authors included Drs. Tina Costacou of Pitt's Graduate School of Public Health, Demetrius Ellis and Dorothy Becker of Children's Hospital, and Ronald Klein of the University of Wisconsin Medical School.

By: Joe Fahy | Pittsburgh Post Gazette
Friday, April 28, 2006


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