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Which Comes First?

The risk of heart disease begins about 15 years before a clinical diagnosis of type 2 diabetes in women, and it is nearly as high before the women develop diabetes as it is after diagnosis, say researchers who have been studying 117,629 female nurses since 1976. None of the women studied had signs of heart disease at baseline.

Before they were diagnosed, women who developed type 2 diabetes had an age-adjusted risk of having a heart attack, a stroke or coronary heart disease 3.75 times greater than that faced by women in the group who did not have diabetes. After diagnosis, the women with type 2 faced a risk 4.57 times greater than that of the other women.

Researchers note that increasing body mass index was “significantly associated with an increased risk of heart disease and stroke.” Findings “suggest that aggressive management of cardiovascular risk factors is warranted in individuals at increased risk for diabetes.”

Diabetes Care, July 2002

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