Cardiovascular events and mortality in people with and without type 2 diabetes: An observational study in a contemporary multi‐ethnic population

Abstract

Aims/Introduction The aim of this study was to examine ethnicity‐specific associations between type 2 diabetes mellitus and the risk of a cardiovascular disease (CVD) event as well as risk of specific CVD phenotypes in England. Methods We obtained data from the Clinical Practice Research Datalink for adults with and without type 2 diabetes mellitus diagnosed 2000–2006. The outcome was the first CVD event during 2007–2017 and the following components: aortic aneurysm, cerebrovascular accidents, heart failure, myocardial infarction, peripheral vascular disease and other CVD‐related conditions. Flexible parametric survival models were used to estimate ethnicity‐specific adjusted hazard ratios. Results A total of 734,543 people with and without type 2 diabetes mellitus (29,847; 4.1%) were included; most were of white ethnicity (93.0% with and 92.3% without type 2 diabetes mellitus) followed by South Asian (3.2 and 4.6%). During a median follow‐up period of 11.0 years, 67,218 events occurred (6,156 in individuals with type 2 diabetes mellitus). Type 2 diabetes mellitus was associated with a small increase in CVD events (adjusted hazard ratio 1.06, 95% confidence interval 1.02–1.09) in individuals of white ethnicity; whereas the adjusted hazard ratios were considerably higher in individuals of South Asian ethnicity (1.28, 95% confidence interval 1.09–1.51), primarily due to an increased risk of myocardial infarction (1.53, 95% confidence interval 1.08–2.18). Conclusions Despite universal access to healthcare, there are large disparities in CVD outcomes in people with and without type 2 diabetes mellitus. Other non‐traditional risk factors might play a role in the higher CVD risk associated with type 2 diabetes mellitus in individuals of South Asian ethnicity.

Improved Survival and Retinal Function of Aging ZDF Rats in Long-Term, Uncontrolled Diabetes by BGP-15 Treatment

“…Based on our OGTT results, BGP is not likely to exert the aforementioned prevention by settling glucose homeostasis; although, some significant differences were demonstrated in our present study (Figures 3, 4), instead the action of it might have some relationship to oxidative stress. Diabetes, even type II diabetes, is associated with higher risk of mortality (Coles et al, 2020), probably due to the accompanying oxidative stress (Rosales-Corral et al, 2015), which is proven to be among the causes of macro-and microcirculatory complications of diabetes (Madonna et al, 2017;Frisbee et al, 2019). Although at this point we have little information on the exact mechanism of action of BGP-15, it is at least a very telling result that no BGP-treated animals died during the 12 months spent in diabetes.…”

Body composition analysis components as markers for coronary artery diseases in type 2 diabetic patients

“…Our results emphasise the need for conducting body composition analysis in screening for CAD. Since the relative risk of CAD is linked (20–50%) with higher mortality in the Asian Indian population in comparison to other populations, 33 it necessitates the presence of robust screening strategies along with health education and awareness to improve health.…”

Ethnicity and prognosis following a cardiovascular event in people with and without type 2 diabetes: Observational analysis in over 5 million subjects in England

“…country [4]. Furthermore, CVD eventssuch as heart failure and myocardial infarctiontend to occur earlier in South Asians compared to other ethnicities [5][6][7][8][9]. More limited and contrasting is the evidence about the prognosis following a CVD event: initial, very small studies in the UK have suggested higher mortality rates in South Asians compared to White Europeans following a myocardial infarction [10], while more recent observations, based on much larger samples, have reported a similar [7,9,11] or lower [12] risk.…”

“…More limited and contrasting is the evidence about the prognosis following a CVD event: initial, very small studies in the UK have suggested higher mortality rates in South Asians compared to White Europeans following a myocardial infarction [10], while more recent observations, based on much larger samples, have reported a similar [7,9,11] or lower [12] risk. Detailed UK data on the risk of a first CVD event and the prognosis following the event are more limited for other ethnic groups [8,[13][14][15].…”