Mensen met diabetes leven 15 jaar korter*
Diabetici
worden gemiddeld vijftien jaar eerder getroffen door hart- en vaatziekten dan
andere mensen. Dat blijkt uit een studie in het vakblad The Lancet. Onderzoekers
uit Toronto vergeleken de gezondheidsgegevens van 379.000 volwassen diabetespatiënten
in de provincie Ontario met die van de overige 9 miljoen inwoners. Ze kwamen tot
de bevinding dat mannen met diabetes al op 48 jaar een hoger risico lopen op
hartinfarct en beroerte. Bij vrouwen zou dat vanaf 54 jaar het geval zijn.
Diabetici moeten daarom veel sneller hun voorzorgen nemen, menen de
onderzoekers.
The
Lancet 2006; 368:29-36
DOI:10.1016/S0140-6736(06)68967-8
Relation
between age and cardiovascular disease in men and women with diabetes compared
with non-diabetic people: a population-based retrospective cohort study
,
, and
Summary
Background
Adults
with diabetes are thought to have a high risk of cardiovascular disease (CVD),
irrespective of their age. The main aim of this study was to find out the age at
which people with diabetes develop a high risk of CVD, as defined by: an event
rate equivalent to a 10-year risk of 20% or more; or an event rate equivalent to
that associated with previous myocardial infarction.
Methods
We
did a population-based retrospective cohort study using provincial health claims
to identify all adults with (n=379 003) and (n=9 018 082)
without diabetes mellitus living in Ontario, Canada, on April 1, 1994.
Individuals were followed up to record CVD events until March 31, 2000.
Findings
The
transition to a high-risk category occurred at a younger age for men and women
with diabetes than for those without diabetes (mean difference 14·6 years). For
the outcome of acute myocardial infarction (AMI), stroke, or death from any
cause, diabetic men and women entered the high-risk category at ages 47·9 and
54·3 years respectively. When we used a broader definition of CVD that also
included coronary or carotid revascularisation, the ages were 41·3 and 47·7
years for men and women with diabetes respectively.
Interpretation
Diabetes
confers an equivalent risk to ageing 15 years. However, in general, younger
people with diabetes (age 40 or younger) do not seem to be at high risk of CVD.
Age should be taken into account in targeting of risk reduction in people with
diabetes.
Affiliations
Department of Medicine, University of Toronto,
Toronto, Ontario, Canada
Department of Medicine, St Michael's Hospital,
Toronto, Ontario, Canada
Department of Medicine, University Health Network,
Toronto, Ontario, Canada
Department of Medicine, Sunnybrook and Women's
College Health Sciences Centre, Toronto, Ontario, Canada
The University Health Network Women's Health
Program, Toronto, Ontario, Canada
The Institute for Clinical Evaluative Sciences,
Toronto, Ontario, Canada
(Juni 2006)