Diabetics are at risk of developing cardiovascular disease, one of the world's biggest killers, 15 years earlier than other people, according to a scientist. So a person with diabetes aged 40 has the same odds of having a stroke or heart attack as a healthy person of 55.
"Diabetes confers the same risk of cardiovascular disease as ageing 15 years," said Gillian Booth of the Institute of Clinical Evaluation Sciences in Toronto, in an interview. But she added that not all people with diabetes are at high risk. Those that are do not reach the high level until they are in their early to late 40s.
Diabetes is a chronic illness that occurs when the body does not produce enough, or effectively use insulin. Men with diabetes usually go from the moderate to high risk category at about 41 years old while in women it is 48.In the general population it occurs 15 years later. "People with diabetes certainly are at a high risk of getting heart disease and there is a shift towards early heart disease, so the effect is quite significant," Booth added.
In research reported in The Lancet medical journal, Booth and her team also showed that young adults with diabetes have rates of coronary heart disease 12-40 times higher than those in people without diabetes. The scientists assessed the age at which diabetics develop a high risk of cardiovascular disease by looking at 379,000 people with the illness in Ontario and more than 9 million residents without it.
By recording when heart attacks and strokes occurred in the two groups between April 1994 and March 2000, the researchers determined the increased risk.
Diabetes, which is linked to obesity, also carries an increased risk of kidney damage and nerve disorder that can lead to amputations. The World Health Organisation estimated that the number of people worldwide with diabetes in 2000 was 177 million. It is expected to rise to 300 million by 2025.
Although diabetics have a raised risk of heart attack or stroke, Booth said not all people with the illness have the same level of risk and should not receive the same medical treatment.
Treatments to reduce the risk of cardiovascular disease include moderate exercise and a healthy diet, cholesterol-lowering drugs, low-dose aspirin and drugs such as Ace inhibitors to lower blood pressure. "We should be individualising treatment (of diabetics), rather than treating them all the same," said Booth.
Computer System helps
A new computer system that tracks trends in patient care has resulted in a large increase in the number of diabetes patients learning to control their blood sugar levels, Singapore General Hospital (SGH) said on Friday.
The greatest improvement has been seen among patients under 30, but doctors said inroads were recorded across all age groups. The system helps administrators and researchers "understand the big picture of the disease, the cost of the disease and the services required," The Straits Times quoted Dr Daphne Khoo, head of endocrinology, as saying. It enables the hospital to monitor patient care.
The "datamart" has captured information from 30,000 patients. Part of the plan is to build a "community portal" that selects general practitioners will have access to, Khoo said. The move would encourage patients’ not needing specialist care to go to their family doctors instead.
Because of overcrowding, patients in the hospital end up waiting two hours or more to see a doctor. Only half of them have been found to need that high level of care.
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