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CV Outcomes Improved in Those With, Without Type 2 Diabetes

In Australian cohort, reductions in MI, stroke, CVD death seen in those with type 2 diabetes

FRIDAY, May 1, 2020 (HealthDay News) — Cardiovascular outcomes have improved since the 1990s, especially for individuals with type 2 diabetes, according to a study published online April 30 in the Journal of Clinical Endocrinology & Metabolism.

Wendy A. Davis, Ph.D., from the University of Western Australia in Fremantle, and colleagues characterized temporal changes in the incidence rates of chronic complications and mortality in Australian participants with diabetes from the Fremantle Diabetes Study Phases I (FDS1: 1,291 participants, recruited in 1993 to 1996) and II (FDS2: 1,509 participants, recruited in 2008 to 2011). Participants were age-, sex-, and zip code-matched to people without diabetes in a 1:4 ratio, with a total of 13,995 participants.

The researchers found lower incidence rate ratios for myocardial infarction, stroke, heart failure, and cardiovascular disease (CVD) death in FDS2 versus FDS1. For participants with versus without type 2 diabetes, the incidence rate differences (IRDs) were reduced by more than 50 percent between phases for myocardial infarction, stroke, heart failure, lower extremity amputation, and CVD death; no change was seen in the IRD for all-cause mortality. After adjustment for covariates, in the pooled type 2 diabetes cohort, FDS2 versus FDS1 participation was an independent inverse predictor of stroke, heart failure, CVD death, and all-cause mortality.

“There appear to be factors other than improved CVD risk factor management underlying the improved outcome between FDS phases,” the authors write. “The gap in all-cause mortality between those with and without type 2 diabetes persists, but survival is increasing in both groups.”

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