Type 2 Diabetes and Blood Vessel Damage

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Meigs JB, Uh FB, Rifadin N, et al.: Biomarkers of endothelial dysfunction and the risk of type 2 diabetes mellitus. JAMA 291:1978–1986, 2004.

 

What is the problem and what is known about it so far? 

Type 2 diabetes can often be prevented, but doctors are still unsure what really causes it.

The researchers wanted to investigate the link between diabetes and cardiovascular disease (disease of the heart and blood vessels). Type 2 diabetes can cause heart disease but it can also be caused by it, so diabetes and heart and blood vessel disease may share a common cause.

If the cause that predicts both type 2 diabetes and heart and blood vessel disease can be found, it may be possible to predict if a person will get type 2 diabetes.

Who was studied? 

The researchers studied 737 women originally enrolled in the Nurses Health Study between 1989 and 1990. None of the women had heart or blood vessel disease, diabetes, or cancer.

A second group of 785 women served as the “control” (comparison) group and were selected to match the other women in age, race, and blood test results.

By 2000, 737 women had developed type 2 diabetes. The researchers reassessed the factors linked to type 2 diabetes. The women gave blood samples on a regular basis. The researchers checked the samples for early signs of atherosclerosis (hardening of the arteries) and early signs of other problems with blood vessels.

What did the researchers find?

Women who got type 2 diabetes during the 10 years of follow-up were more likely to have diabetes in the family, drink less alcohol, eat unhealthy foods, not exercise much, and use less hormone replacement therapy after menopause.

Those women having more problems with blood vessel cells were more likely to get type 2 diabetes.

What were the limitations of the study?

The researchers studied how well blood vessels worked only through one type of test. Other tests showing how the cells were working could have affected the results.

Also, the researchers didn’t measure fatty acids and other things linked to blood vessel problems and diabetes.

Finally, most of the participants were healthy white women between the ages of 30 and 55. A similar study with a more varied group of participants may result in different findings.

What are the implications of the study?

Women having problems with blood vessels are more likely to get type 2 diabetes. Blood vessel problems may be a common cause of both heart or blood vessel disease and type 2 diabetes.

Treatments that improve blood vessel function may prove important in preventing type 2 diabetes and related health problems.