Malays, Indians with Type 2 diabetes have higher risk of heart attacks & strokes
Good control of blood glucose and smoking cessation may significantly reduce this risk of adverse cardiovascular outcomes.
The prevalence of diabetes in Singapore is increasing rapidly. The latest national health survey suggested that about 11 percent of Singapore adults have diabetes with approximately 90 percent of these having Type 2 diabetes, the most common form of diabetes. This condition results from the body’s inability to produce adequate insulin (a hormone that controls blood glucose) and utilise insulin effectively. Cardiovascular diseases including heart attack and stroke are the main causes of morbidities and premature death in those with Type 2 diabetes.
A team from Khoo Teck Puat Hospital’s (KTPH) Clinical Research Unit, Clinical Services, Diabetes Centre and Department of General Medicine conducted a large-scale, decade-long longitudinal study to find out the long-term outcomes of cardiovascular diseases in different ethnic groups living in Singapore. This recent study looks at the patient’s ethnicity as well as risk of complications from Type 2 diabetes.
The study recruited 2,337 patients from Alexandra and Khoo Teck Puat Hospitals with Type 2 diabetes from 2002 to 2011. The patients were on average 58 years old and had diabetes for at least 12 years. Among the subjects, 69 percent were Chinese, 18 percent Malay and 13 percent Indian. The investigators followed the patients for an average of 4.5 years.
They found that Malays had a two times higher risk, and Indians a 1.7 times higher risk of cardiovascular diseases compared to the Chinese patients. Further analysis suggests that the higher risk in Malays may be attributed to the greater prevalence of diabetic kidney disease (DKD). On the other hand, increased risk in Indians may be partially explained by conventional vascular risk factors such as high blood pressure and lipid disorders.
The findings suggest that greater interventional efforts targeting patient education, lifestyle modifications, early detection of renal injury and intensive control of cardiovascular risk factors will be useful in helping Malay and Indian patients to better manage Type 2 diabetes and reduce cardiovascular risk associated with the condition. The investigators also found that good control of blood glucose level and smoking cessation may significantly reduce the risk of cardiovascular diseases in patients with Type 2 diabetes regardless of ethnicity.
The study authors highlight that all patients with Type 2 diabetes should make lifestyle modifications such as exercising regularly, eating healthily and quitting smoking to better manage their health condition.
(* PHOTO CREDITS: Blood glucose measure, rotorhead, freeimages and cigarette in hand, mi-sio, freeimages)