The study tracks trends in diabetes and deaths related to cardiovascular disease

After an initial decline in diabetes (DM) as well as cardiovascular disease (CVD)-related deaths, researchers have observed a reversal of this trend as the death rate increased from 2014 to 2019, according to a new study in American Journal of Medicine, published by Elsevier. Diabetes mellitus, which is a significant risk factor for CVD complications, has been on the rise in recent years. More than 37 million adults in the United States (about 15% of that population) are reported to have diabetes, in addition to eight million adults living with an undiagnosed disease.

Co-principal investigator Vardhmaan Jain, MD, Department of Cardiology, Emory University, explained, “Heart disease remains the number one killer in the United States despite advances in drug development. Because patients with diabetes are disproportionately affected by CVD, we conducted a “The report published an updated epidemiological analysis to determine the current scale of the problem. Diabetes remains a major risk factor with a two- to four-fold increased risk of cardiovascular disease and a three-fold increased risk of cardiovascular death.”

Investigators used the Centers for Disease Control and Prevention’s extensive online database of epidemiological research (CDC WONDER) to identify deaths in adults, ages 25 and older, for whom both CVD and diabetes were an underlying or contributing cause of death from 1999. to 2019. Their analysis revealed additional patterns of diabetes-related deaths and CVD-related deaths over the past 20 years, including the following:

• Males and non-Hispanic adults were more affected than other demographic subgroups.
• The age-adjusted mortality rate was higher for non-Hispanic adults and was more than twice as high as for non-Hispanic white adults.
• There was an alarming rise in mortality rates related to diabetes and cardiovascular disease in younger adults (25-54 years) and middle-aged adults (55-69 years) during the latter part of the study period.
• There was a higher burden of mortality in rural areas than in urban areas – and this difference widened over time.
• Hotspots of high mortality associated with DM + CVD were evident in the Midwestern, Western, and Southern states.

The introduction of newer treatments and updated management guidelines has transformed the management of diabetes and cardiovascular disease in the past two decades, offering the potential to enhance an individual’s life expectancy. However, several factors make these advances out of reach for large parts of the United States, including rising health care costs and pre-existing disparities in access to care. Higher levels of hypertension, hyperlipidemia, obesity, smoking, and lower levels of physical activity also contributed to these negative trends; Control of modifiable risk factors may be far from optimal in patients with DM.

High costs, disparities in health care, and public/private policies all play an important role in who gets access to these new treatments. The demographic and geographical differences can also be attributed to higher levels of chronic disease, poverty and fragmented care in rural areas.”

Salim S. Virani, MD, co-author, Department of Cardiology, Baylor College of Medicine

Co-principal investigator Abdul Manan Khan Minhas, MD, Department of Medicine, University of Mississippi Medical Center, said, “Our updated estimate of the burden of mortality associated with cardiovascular disease + diabetes is important for informing policy measures and identifying focus areas for targeted interventions. Taken together, these findings indicate “The need for primary prevention of diabetes, awareness-raising, early diagnosis and close monitoring of heart disease-related risk factors among diabetics to prevent cardiovascular complications and mortality. Targeted interventions are required to prevent lost years of progress, with a focus on prevention and reducing disparities.”

Dr. Jain added, “Improving population-level control of diabetes could have far-reaching positive effects on life expectancy.”