Surgical Tribune Europe

Women affected most by vascular complications of diabetes

By Hospital Healthcare Europe
November 22, 2019

AMSTERDAM, Netherlands: Globally, there are more deaths due to diabetes in women than in men (2.1 versus 1.8 million annually). This excess risk is mainly owing to the higher risk of cardiovascular death in women. A recent study has now found that women are more affected by vascular complications caused by diabetes.

Coronary heart disease is the most frequently reported form of cardiovascular disease and the most lethal one. Women with diabetes are at a 1.81-fold risk of death from coronary heart disease compared to women without diabetes. Men with diabetes have a 1.48-fold risk of death from coronary heart disease compared to men without diabetes.

Peripheral artery disease—which can ultimately lead to foot amputation—is the most common initial manifestation of cardiovascular disease in patients with type 2 diabetes. Its prevalence is 1.8-fold higher in women compared to men.

Heart failure is the second most common initial manifestation of cardiovascular disease in type 2 diabetes. Women with diabetes are five times more likely to get heart failure than women without diabetes. Men with diabetes are two times more likely to get heart failure than men without diabetes.

Research is ongoing to explain these differences between women and men. One possible reason for the higher heart failure risk could be that a specific form is more common in women generally and is the type most likely to affect patients with diabetes. This form is called heart failure with preserved ejection fraction, where the heart maintains its pump function but has increased stiffness causing impaired relaxation after contraction.

In both women and men, a healthy lifestyle is the cornerstone to preventing diabetes; once people have diabetes, it is fundamental to stopping the cardiovascular complications.

Senior author Prof. Joline Beulens, of Amsterdam University Medical Centre, said: “With the increased levels of obesity in our society we have seen an enormous rise in the prevalence of diabetes. We know that type 2 diabetes is a lifestyle-related disease, so we can halt the trajectory with better behaviours.”

“Lifestyle management is the first line of treatment for patients with diabetes,” continued Beulens. “If lifestyle doesn’t sufficiently control glucose levels and the risk of complications, then glucose-lowering treatment should be initiated as the second line of therapy.”

“Patients with diabetes remain at significantly higher cardiovascular risk compared to people without diabetes. There is an urgent need to better identify, monitor, and control diabetes to prevent the devastating cardiovascular complications,” concluded Beulens.

The study, titled “Diabetes as a cardiovascular risk factor: An overview of global trends of macro and micro vascular complications”, was published in the Journal of Preventive Cardiology.


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