September 2, 2010

Diabetes Does Not Create Risk Just like Having Had a Heart Attack: Another Drug Company Myth Debunked

You've probably been told that because you have been diagnosed with diabetes your risk for a heart attack is the same as that of a person who has already had one.

This turns out to be pure bullpucky.

A study published in Diabetes Care this month followed for ten years 4,410 patients aged 30–74 years: 2,260 with type 2 diabetes without coronary heart disease recruited in 53 primary health care centers and 2,150 people who had already had a heart attack but did not have diabetes.

Here's what they found:
The adjusted hazard ratios (HRs) [i.e. risk] for 10-year coronary heart disease incidence and for cardiovascular mortality were significantly lower in men and women with diabetes than in myocardial infarction patients... All diabetic patient subgroups had significantly fewer events than myocardial infarction patients.
Long-Term Cardiovascular Risk in Type 2 Diabetic Compared With Nondiabetic First Acute Myocardial Infarction Patients: A population-based cohort study in southern Europe J. Francisco Cano et al. Diabetes Care, September 2010 vol. 33 no. 9 2004-2009. doi: 10.2337/dc10-0560

Don't expect the statin drug reps to tell this to your family doctor. Selling the idea that people with diabetes "already have heart disease" has been very profitable to the drug companies. But if you've been worrying yourself sick over it, relax.

In fact, given the close relationship of post-meal blood sugar levels to heart attack incidence in all groups of people--those with and without diabetes diagnoses, it's very possible that people with diabetes who keep their blood sugars under 140 mg/dl as much as possible will have fewer heart attacks than their "healthy" peers.

You can learn more about how blood sugar level predicts heart attack far better than cholesterol levels here: A1c and Post-Meal Blood Sugars Predict Heart Attack


Scott S said...

I have questioned this logic (e.g. the risk for PWD's vs. those who have already had heart disease) for a long time, and I question whether ubiquitous prescription of statin drugs will actually reduce the incidence at all, because the evidence is anything but clear. Yet our healthcare system is paying billions for this, and the long-term health outcomes? Unproven. When the patents end for these drugs (which is right around the corner), we may see that they do little more than add to the unnecessary waste already so prevalent in the nation's healthcare system.

Boz said...

I was taking a statin since I was diagnosed w/ type 2 five years ago. Since then, I was constantly had sore muscles and joints. My doctor said it was age and over-use. About 3 weeks ago, I quit taking it, and low and behold, the aches and pains are gone. My cholesterol has always been low, but the doctors say the like to treat type 2 patients as if they have already had a heart attack. Diabetes runs in my family, but heart disease doesn't. I just wish I had questioned the statin five years ago.....