The effect of diabetes on health is equivalent to ageing 15 years, according to an article in this week's issue of The Lancet. Canadian researchers found that people with diabetes fell into the high-risk category for cardiovascular disease (CVD)* 15 years earlier than those without diabetes.

People with diabetes are up to four times more likely to have CVD as people without diabetes. In the past 5 years, increasing evidence has emerged that lends support to the use of cardioprotective agents, such as statins and aspirin, in patients with diabetes. However, the age at which to start such treatment has been unclear.

To investigate, Gillian Booth (Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada) and colleagues assessed the age at which people with diabetes develop a high risk of CVD. They studied the majority of the population of Ontario, Canada, which consisted of 379 000 people with diabetes and over 9 million without the disease. The investigators recorded any cardiovascular events in this group between April 1994 and March 2000. They found that diabetes led to earlier CVD; diabetic men and women were about 15 years younger than those without diabetes in the same risk category. For those who had a heart attack, stroke, or died from any cause, the transition from moderate to high risk of CVD took place at about age 48 years for men with diabetes and 54 years for women with diabetes. When the researchers included cardiovascular procedures (eg bypass surgery) in the definition of CVD, this transition took place at age 41 years for men with diabetes and 48 years for women with diabetes.

"Middle-aged and older people with diabetes seem on average to be at high risk of CVD, thus aggressive risk-reduction strategies are warranted for them. Appropriate thresholds for younger people with diabe
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Contact: Joe Santangelo
j.santangelo@elsevier.com
212-633-3810
Lancet
29-Jun-2006