A diagnosis of prediabetes should be a warning for people to
make lifestyle changes to prevent both full-blown diabetes and cardiovascular
disease (CVD), according to a study published in the journal Diabetes Care. The study findings support
the importance of blood glucose monitoring in midlife for CVD prevention.
“We know that having diabetes increases the risk of
developing cardiovascular disease, so in our study we wanted to determine what
the absolute risk or probability of developing heart disease was for people who
were only at a pre-diabetic level of blood glucose,” said the study’s lead
author Michael P. Bancks, PhD, assistant professor of epidemiology and
prevention at Wake Forest’s medical school, a part of Wake Forest Baptist
Prediabetes is indicated by a fasting blood sugar level
between100 and 125 mg/dL (5.6 to 6.9 mmol/L), while a fasting blood sugar level
of less than 100 mg/dL (5.6 mmol/L) is considered normal. A level of 126 mg/dL
(7 mmol/L) and higher is the diagnostic threshold for diabetes, Bancks said.
In the study, the researchers used data from seven
observational studies that included both white and black men and women who were
followed from 1960 through 2015. Prior research focused on white Americans of
European descent, whereas this study included African-Americans so the findings
could be generalised to a broader population, Bancks said.
The sample included 19 630 individuals who had not had a
prior CVD event, considered here as heart disease or stroke. Absolute risk of
CVD was determined through analysis of participants’ fasting glucose category
beginning at age 55 through 85.
Bancks and colleagues found that the risk for CVD ranged
from 15% (non-diabetic) to 38% (diabetic) among women and from 21%
(non-diabetic) to 47% (diabetic) among men. Increases in glucose to the
diabetic level during mid-life were associated with substantially higher
cardiovascular risk than when glucose levels stayed below the diabetes
“Although we found that individuals who had pre-diabetic
levels of blood glucose did not have a higher absolute risk for cardiovascular
disease, we know that most people go on to develop diabetes unless they take
measures to reduce their blood glucose levels,” Bancks said.
“Our study provides further evidence that if you can avoid
diabetes you may be able to stave off cardiovascular disease. Pre-diabetes
should serve as a red flag to doctors to closely monitor their patient’s blood glucose
to try to prevent diabetes through lifestyle interventions like better diet and
increased physical activity, and if necessary, with pharmacologic therapies.”
MP, et al. Long-Term Absolute Risk for Cardiovascular Disease Stratified by
Fasting Glucose Level. Diabetes Care, January 2019.