Article Synopsis |  | A study by Haffner et al. published in the New England Journal of Medicine showed that diabetic subjects without prior myocardial infarction (MI) have as high a risk of MI as non-diabetic subjects with prior MI. These findings were “population based” according to the investigators, but were actually obtained from a population register of diabetic subjects.
A five year follow-up analysis of the Dubbo Study, an ongoing prospective study of cardiovascular disease in a cohort of elderly Australians which commenced in 1988-89, showed that overall mortality was twice as high in diabetic subjects as in non-diabetics, among both men and women. The incidence of coronary heart disease was two times as high in diabetic men and three times as high in diabetic women.
A cox proportional-hazards model was used in the 98 month follow-up to compare the risk of coronary heart disease in subjects who had diabetes but no prior coronary heart disease with the risk in non-diabetic subjects with or without prior coronary heart disease. The findings confirmed an overall increase of coronary heart disease in patients with type 2 diabetes. However, the relative risk for diabetic subjects without prior coronary heart disease is still significantly lower than that for non-diabetics subjects with prior coronary heart disease.
The difference between the findings of the two studies may be related to differences in the selection criteria for the study populations, the definition of diabetes, the age and size of the groups, and the different endpoints. |