Can Diabetic Medication Lower Heart Disease Risk?
While the disease diabetes is known to increase risk of heart disease, heart attacks and strokes, medical researchers are now looking into the possibility that diabetic medications may actually prevent these health problems. Both new and older drugs and remedies are being investigated for their potential cardioprotective effects.
Diabetes occurs in two common forms and one less common. Type 2 diabetes, which accounts for around 90% of all diabetics, typically occurs in middle age or older in overweight or obese people. Type 1 usually has its onset before the age of 20 and cannot be prevented, as far as is known, by lifestyle changes. Pregnancy diabetes, which is far less common, is a temporary condition affecting pregnant women and usually disappears after the birth of the child.
The first two forms of diabetes are associated with many health concerns, including an increased incidence of heart disease, heart attacks and strokes. While managing the disease well will lower these risks and give the patient a longer, healthier life, decreased likelihood of cardiovascular disease may also be associated with the very medication the diabetic has to take. The study of statistics relating to diabetic patients has thrown up evidence that even insulin, the missing hormone that diabetics need to live, can itself reduce the risk of heart disease.
While some diabetic drugs have been associated with increased incidence of heart attacks and some have been withdrawn, older drugs and some new ones could actually work as preventatives.
Dr Bruce Neal from the George Institute for Global Health,Sydney,Australia, told a scientific audience inOrlando,Florida, that modern SGLT2 inhibitors like dapagliflozin have been linked with improved blood glucose levels, weight loss, improved blood pressure and even slight improvements in cholesterol levels. He said scientists recognize there is also a link with decreased cardiovascular disease, but more research is needed before they really understand how this works. Scientists are also looking at diabetes medications that have been around for longer, such as the carbohydrate blocker acarbose, which stops blood glucose spiking after a meal and helps keep it stable and level. Acarbose has been used since the 1990s, and one study associated it with a 49% reduced development of cardiovascular disease in patients with impaired glucose tolerance.
Two studies also associated insulin, the hormone which is lacking in diabetics, with reduced risk of heart disease. Results from the Diabetes Control and Complications Trial, which ran from 1983 to 1993, linked insulin injections with a 42% lower risk of cardiovascular disease in patients over 20 years. And a similar study in theUKwhich chose random patients for intensive insulin or sulfonylurea therapy found these patients were 15% less likely to have heart attacks and 13% less likely to die from other causes during the 20 years.
One explanation for the reduced cardiovascular disease risk is that the weight loss and reduced blood pressure themselves lower the risk of heart attack, but there may be more to it than that. Two further trials are ongoing, with their reports due next year.
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