Complications > Cardiovascular disease

English

Anthropometric indicators of obesity for identifying cardiometabolic risks in a rural Bangladeshi population – Chandra Diabetes Study

Professor Akhtar Hussain’s aim of studying anthropometric indicators of obesity was to evaluate the predictive ability of body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio and body fat percentages for the presence of cardiometabolic risks—namely type 2 diabetes, hypertension, dyslipidemia and the metabolic syndrome.

Diabetes, diabetes treatment and cancer risk

To say that the diabetes world has been rocked by recent revelations about cancer might be too strong a term; but it certainly has been shaken. A growing bank of data over the last few years has put cancer very much 'on the radar’ of diabetes clinicians and researchers alike. Andrew Renehan tells the stories behind the headlines.

A multidisciplinary effort to improve the quality of chronic disease care

Although chronic diseases are leading causes of death and disability, they are neglected elements of the global health agenda. Of all deaths worldwide in 2005, 60% were caused by chronic diseases – principally cardiovascular diseases and diabetes (32%), cancer (13%), and chronic respiratory diseases (7%). Because the increase in chronic diseases is underappreciated, and their economic impact underestimated, many countries take little interest in their prevention, and leave the responsibility for management to individuals.


A gender perspective of diabetes and cardiovascular disease - the need for deeper understanding

Rates of diabetes continue to increase rapidly around the world. The current prevalence of about 5.1% is set to rise to 6.3% by 2025 – 333 million people with the condition. Further huge numbers of people are unaware that they have undiscovered diabetes and pre-diabetes conditions. The number of people with impaired glucose tolerance will increase from 314 million to 472 million over the next 15 years or so. These people are at dangerously high risk both for future diabetes complications and early death through cardiovascular disease.

The results and implications of the ACCORD and ADVANCE trials

Recently, two clinical trials addressed the role of tight blood glucose control on cardiovascular risk in people with type 2 diabetes: the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study and the Action in Diabetes and Vascular Disease (ADVANCE) trial. The ACCORD study included 10,251 people with type 2 diabetes and was designed to determine whether intensive blood glucose control (HbA1c below 6%) as compared to a conventional approach (HbA1c between 7% and 7.9%) would result in favourable cardiovascular outcomes in people with type 2 diabetes at high vascular risk.

Metabolic syndrome, diabetes and cardiovascular diseases: a serious link

The metabolic syndrome is becoming a global public health issue. Those affected have higher risk of suffering a heart attack or stroke – as well as of dying from such an event – compared with people without the syndrome. This cluster of factors is closely linked with the worldwide increases in type 2 diabetes, cardiovascular disease and other chronic diseases. The resulting premature deaths and disabilities are set to cripple health budgets in both developed and developing countries. Criteria for diagnosis of the metabolic syndrome entail a combination of cardio-metabolic risk factors.

The North Karelia Project: 30 years successfully preventing chronic diseases

After World War II, chronic diseases, cardiovascular diseases in particular, became a major public health problem in industrialized countries. These diseases were perceived as diseases of affluence. Finland was hit hard: in the 1960s, Finland had the world’s highest rate of deaths from coronary heart disease. Middle-aged men were dying in great numbers. The rates were even higher in the east of the country – the highest figures being in the Province of North Karelia.

The need for tact, openness and honesty when talking about complications

Discussing the sensitive issue of long-term complications is difficult for people with diabetes and the healthcare providers who work with them. Consequently, this area of diabetes management is often not handled well. In some situations, healthcare providers are reluctant to impose 'unpleasant' information on people who might be struggling to cope with diabetes; in others, the potential risk of developing complications might be used as a threat in an attempt to scare people into following medical advice.

Cardiovascular risk, blood pressure, and kidney damage

People with type 2 diabetes suffer badly from heart disease, strokes, and damage to the blood supply to their feet. Indeed, these cardiovascular conditions are the major causes of ill-health and death in people with the condition. A significant proportion of that ill-health is preventable, including by attention to the levels of fats and sugar in the blood, the clotting tendency of the blood, and blood pressure. Raised blood pressure is also responsible for worsening of eye damage and kidney damage in people with type 2 diabetes, and is therefore particularly well worth treating.

Insensitivity to insulin and obesity: the underlying cause

In the late 20th century obesity became an epidemic. The importance of obesity as a risk factor for a number of conditions, including type 2 diabetes, cardiovascular disease, hypertension, gallstones and certain cancers, is well documented. Often associated with insensitivity to insulin, obesity is clearly a key factor in the development of the metabolic syndrome – a risk for both diabetes and cardiovascular disease. In this article, Robert Eckel and Scott Grundy explore the underlying causes of obesity and insensitivity to insulin.

Pages