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Diabetes, dysglycemia are independent risk factors for vascular disease

A comment from Johan De Sutter, on behalf of the EACPR Prevention, Epidemiology and Population Science Section

Diabetes mellitus, fasting blood glucose concentration and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies.
The Emerging Risk Factors Collaboration, Lancet 2010;375:2215-22.

Read the abstract

Diabetes is an established risk factor for coronary heart disease and ischaemic stroke, but uncertainties persist about the magnitude of associations of diabetes and fasting glucose concentrations with CHD and major stroke subtypes.

The present report of The Emerging Risk Factors Collaboration pooled data from 698 782 people coming from 102 cohorts in 25 countries.  The results clearly show that diabetes confers about a twofold excess risk for CHD, major stroke subtypes and death attributed to other vascular causes, independently from other conventional risk factors.  The HRs are also significantly greater in some groups at lower absolute risk of vascular disease- ie. in women, younger ages, non-smokers and a lower than average blood pressure.

In contrast, in people without diabetes fasting blood glucose concentrations appear to be only modestly and non-linearly associated with risk of vascular disease.  Also, information about fasting blood glucose concentration or impaired fasting glucose status does not significantly improve vascular disease prediction beyond the information provided by conventional risk factors.