Type 1 or insulin-dependent diabetes mellitus, prevails among young persons and is a result of dysfunctional insulin production. Type 2, or adult-onset diabetes, also known as non-insulin dependent diabetes (NIDDM), comprises about 90% of all diabetics and majority of diabetic patients that are over 45 years of age. Type 2 diabetes is the most common within middle aged and older adults and it is a significant contributor to morbidity and mortality from CHD.
Recent studies illustrate a positive relationship between high glucose (exceeding normal levels) levels and cardiovascular diseases in men and women, signifying that even non-diabetic persons with high normal fasting glucose levels are at a higher risk for CVD development[1].
Women with an impaired glucose tolerance along with type 2 diabetic women are at a higher risk for CHD compared to their male counterparts[4]. According to Barrett-Connor et. Al,[5] pre-menopausal women who have diabetes are at a higher risk for CHD than diabetic men. Also, women over 45 years of age are more likely to develop diabetes than men. As reported by Framingham cohort study, the risk of CHD in a diabetic woman is increased by 5.4-folds, in comparison to 2.4 fold increase in a diabetic man[2].
Diabetes is also linked to less optimistic outcomes for patients with clinical coronary heart disease. For instance both long term and in hospital prospects of MI are significantly worse among diabetic women than diabetic men and other non-diabetic patients. Diabetic women who have experienced a MI are at a higher risk of death, double their risk of re-infarction, and quadruple their risk of heart failure[3].
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1. Coutinho, M., Gerstein, H.C., Wang, Y., Yusuf, S., (1999) The Relationship Between Glucose and Incident Cardiovascular Events. A Metaregression Analysis of Published Data From 20 Studies of 95, 780 Individuals Followed for 12.4 Years Diabetes Care. 22: 233-40.
2. Kannel, W.B., McGee, D.L., (1979) Diabetes and Glucose Intolerance as Risk Factors for Cardiovascular Disease: The Framingham Study. Diabetes Care, 2: 120-126.
3. Chun, B.Y., Dobson, A.J., Heller, R.F.,(1997) The Impact of Diabetes on Survival Among People with First Myocardial Infarction. Diabetes Care, 20, 704-708.
4. Barrett-Connor, E.L, Cohn, B.A., Wingard, D.L., Edelstein, S.L., (1991) Why is Diabetes a Strong Risk Factor for Ischemic Heart Disease in Women than in Men? The Rancho Bernardo Study. JAMA, 265: 627-631.
5. Barrett-Connor, E.L, Grady, D., (1998) Hormone replacement Therapy Heart Disease, and Other Considerations. Annu Rev Public Health, 19:55-72.
