Budoff, Matthew Jay, MD
Prevalence and severity of coronary and carotid atherosclerosis in young persons with type 2 diabetes in comparison to young healthy adults
General Research Subject: Type 2 Diabetes
Focus: Complications, Complications\ Macrovascular-Atherosclerotic CVD and Human Diabetes
Type of Grant: Clinical Translational Research
Project Start Date: July 1, 2012
Project End Date: June 30, 2015
Diabetes is known to increase risk of heart blood vessel blockages and increase their risk of having a heart attack dramatically. Experts believe that individuals >40 years old who have diabetes require aggressive treatment for coronary artery disease, including cholesterol medications, even if they do not have known heart disease or high cholesterol. However it is not known at what age diabetes starts causing significant increased risk, and type 2 diabetes has been increasing in prevalence among children and adolescents. This raises the need to investigate heart disease in younger persons with diabetes, to evaluate if they would benefit from medications to reduce cardiovascular risk.
This study will investigate the presence and severity of heart disease in young adults (25-40 years old) with type 2 diabetes. Participants will undergo multiple tests to assess plaque in the arteries. One test will require a CT scan of the heart to measure hardening of the arteries and plaque buildup, and the second test will measure thickness of the wall of vessels in the neck by using sound waves. It is likely that heart disease starts much earlier than age 40 in persons with DM2, and these younger patients could benefit from earlier medical therapy administration to stop atherosclerosis. If successful, the current medications prescribed for older persons with diabetes can be selectively started earlier in those who have documented plaque in their heart or neck vessels, and thus apply good preventive therapies to prevent the early onset of a heart attack or stroke.
What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?
This project will evaluate whether young persons with diabetes experience early heart disease. Currently, guidelines call for treatment with cholesterol lowering medications to start at age 40, and we are evaluating younger persons to see if they have buildup of atherosclerosis at a younger age. If we find that a substantial number of younger persons with diabetes have early plaque buildup, it will lead to changes in the guidelines to start therapies at a younger age, or institute some sofrt of testing for heart disease among persons with diabetes to evaluate for this problem. This could reduce heart attack, stroke and death among this at-risk group.
Why is it important for you, personally, to become involved in diabetes research? What role will this award play in your research efforts?
I have been researching early means to detect heart disease, to create an early warning test for patients to find out that they have heart disease and have the ability to start diet, exercise and medications (if necessary) to start reversing or slowing the process. There is no higher risk group that I evaluate than persons with diabetes. They are at markedly increased risk and the age at which this starts is unknown. This study will go a long way to establish the appropriate age for heart disease prevention measures to be instituted.
In what direction do you see the future of diabetes research going?
I believe better prevention is the key. While there are numerous new agents being developed for people who already have diabetes, I believe that early identification and treatment will prevent all or most of the significant complications that these patients face including blindness, kidney disease, heart disease and stroke, among others.
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