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Effective treatment of hypertension in patients with diabetes mellitus
1Baylor College of Medicine, Houston, Texas.
Insights
Atherosclerosis, a major complication of diabetes mellitus (IDDM and NIDDM), causes 80% of diabetic deaths and is the primary reason for hospitalizations. This macrovascular issue significantly increases mortality and disability in diabetic patients.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Diabetology
Background:
- Atherosclerosis is a leading cause of mortality and morbidity in patients with diabetes mellitus (Type I insulin-dependent diabetes mellitus [IDDM] and Type II non-insulin dependent diabetes mellitus [NIDDM]).
- Macrovascular complications, including coronary, cerebrovascular, and peripheral vascular diseases, account for the vast majority of diabetic deaths.
Purpose of the Study:
- To highlight the significant impact of atherosclerosis as a macrovascular complication in diabetes mellitus.
- To underscore the role of atherosclerosis in diabetic mortality, hospitalization rates, and long-term disability.
Main Methods:
- The study analyzes existing data on mortality and hospitalization related to diabetes mellitus and its complications.
- It compares the incidence of atherosclerotic complications in diabetic populations versus non-diabetic populations.
Main Results:
- Atherosclerosis accounts for approximately 80% of all diabetic mortality.
- Coronary atherosclerosis is responsible for 75% of atherosclerotic deaths in diabetics, with a two-fold increase in men and four-fold in women.
- Cerebrovascular and peripheral vascular complications are increased four-fold and five-fold, respectively, and contribute to the remaining 25% of atherosclerotic mortality.
Conclusions:
- Atherosclerosis is the principal cause of mortality, hospitalization, and disability in patients with diabetes mellitus, irrespective of diabetes type.
- Macrovascular complications pose a greater mortality risk than microvascular complications in diabetes.
Abstract:
Atherosclerosis, presenting as macrovascular complications of diabetes mellitus, produces approximately 80% of all diabetic mortality, whether the patient has Type I insulin-dependent diabetes (IDDM) or Type II non-insulin dependent diabetes mellitus (NIDDM). Specifically, 75% of this atherosclerotic macrovascular mortality flows as the outcome of coronary atherosclerosis, which is increased approximately two-fold in men and four-fold in women with diabetes as compared with otherwise matched populations with entirely normal carbohydrate tolerance. The remaining 25% of this atherosclerotic mortality in patients with diabetes mellitus is the result either of accelerated cerebrovascular or of peripheral vascular complications of diabetes, both of which are increased four-fold and five-fold, respectively, in patients with diabetes mellitus, regardless of type. Furthermore, atherosclerosis is the principal cause of hospitalizations for patients with diabetes mellitus. Admissions for this complication account for approximately 77% of total hospitalizations for diabetes owing to complications. Aside from mortality data alone, atherosclerosis is obviously a leading cause of diabetic disability, since it produces patients who are chronic cardiovascular, peripheral or cerebrovascular cripples, perhaps for many years before their ultimate demise. Small blood vessel or microvascular complications of diabetes mellitus, while formerly thought to be the end-stage in the unfolding of the diabetic process, do not appear to have the potential for mortality as do the atherosclerotic large blood vessel complications.(ABSTRACT TRUNCATED AT 250 WORDS)