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 Diabetes has long been linked to an increased risk of heart disease.
Plenty of previous research also ties diabetes to an increased risk
of kidney disease.
Research has been mixed, however, on whether slightly elevated blood
sugar that is sometimes called “pre-diabetes” might also increase
the risk of heart and kidney issues. Even the name “pre-diabetes” is
controversial, and doctors disagree on how to diagnose and treat
people with only mildly abnormal blood sugar.
For the study, published in The Lancet Diabetes and Endocrinology,
researchers examined a nationally representative sample of 27,971
adults surveyed in four waves from 1988 to 1994, 1999 to 2004, 2005
to 2010 and 2011 to 2014. By the broadest definition of
pre-diabetes, researchers estimated the number of adults with
pre-diabetes increased from 56.2 million at the start of the study
period to 78.5 million by the end.
For the study, prediabetes was defined as a fasting blood glucose
level of 100 to 125 mg/dL or a hemoglobin A1c level of 5.7% to 6.4%.
By the end of the study, many people with pre-diabetes had risk
factors for heart and kidney problems: 37 percent had high blood
pressure, 51 percent had high cholesterol, 24 percent smoked, 5
percent had reduced blood filtration by the kidneys, and 8 percent
had elevated levels of the protein albumin in the urine that suggest
impaired kidney function.
“Pre-diabetes is extremely common,” said lead study author Dr.
Mohammed Ali, a researcher at Emory University and for the U.S.
Centers for Disease Control and Prevention in Atlanta.
While the study wasn’t a controlled experiment designed to prove
whether or how reducing slightly elevated blood sugar might reduce
the risk of heart or kidney problems, lifestyle changes like
increased exercise and a healthier diet might help people reduce
blood sugar and their risk of health problems that can accompany
diabetes, Ali said by email.
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“Patients who are told they have pre-diabetes should work with their
providers to actively address it and initiate sustainable lifestyle
changes and/or medications,” Ali advised.
Limitations of the study include the potential that the diabetes
assessments used might have underestimated the number of people with
slightly elevated blood sugar, the authors note. Researchers didn’t
have results from what’s known as an impaired glucose tolerance
test, which may be a better indication of the risk of heart and
kidney disease than the alternative tests used in the study.
Still, the results offer fresh evidence of the health risks
associated with pre-diabetes, said Mika Kivimaki, a researcher at
University College London in the U.K. who wasn’t involved in the
study. However, the evidence is stronger for the connection with
kidney disease than heart disease, Kivimaki said by email.
“Obesity, elevated blood pressure, high cholesterol and smoking are
much more important risk factors for cardiovascular disease and are
therefore the main targets of cardiovascular disease prevention,”
Kivimaki said.
But people with slightly elevated blood sugar should still take
steps to get it down to a healthy level.
“I believe people with elevated blood sugar would benefit from
adopting a healthy lifestyle and keeping blood pressure and
cholesterol at healthy levels because all these have several
favorable effects, including a reduced risk of diabetes,
cardiovascular disease and kidney problems,” Kivimaki added.
SOURCE: http://bit.ly/2FXk7Mp Lancet Diabetes and Endocrinology,
online February 28, 2018.
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