Diabetes Death Risk Unexplained

Diabetes mortality risk not explained by traditional risk factors

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) People with diabetes have a higher risk of death than those who don't. It is generally thought that this heightened death risk is caused by traditional risk factors like obesity and heart problems.

In a recent study, researchers found that traditional risk factors for death - including diet, physical activity, obesity, high blood pressure, high blood fats and previous heart disease or cancer - could not explain the increased risk of death in diabetes patients.

In other words, these traditional risk factors were not the cause of diabetes patients' increased risk of death.

"Exercise and eat healthy to help prevent diabetes."

Enrique Regidor, MD, PhD, of the Universidad Complutense de Madrid in Spain, and colleagues wanted to see if they could identify possible factors that explain the relationship between diabetes and increased risk of death.

The researchers compared the risk of death in people with diabetes versus those without diabetes.

In their first analysis, the researchers adjusted for age, marital status, level of education, social class, medical consultation, and treatment with statins, aspirin or angiotensin II antagonists. In other words, they threw out these factors, which are associated with death risk.

Dr. Regidor and colleagues found that people with diabetes had a higher risk of death than their non-diabetic counterparts, with a hazard ratio of 1.40 for men with diabetes and 1.70 for women with diabetes.

A hazard ratio explains how often one event - in this case, death - happens in one group versus another. If one group has a hazard ratio of more than one, it means that the event happens more in that group than the other.

After adjusting for even more death risk factors - including heart disease and cancer - the death risk in diabetes patients versus non-diabetes patients did not change much, with a hazard ratio of 1.43 for men and 1.67 for women.

"The excess risk of [death] in diabetic versus non-diabetic individuals cannot be explained by [death] risk factors or by the presence of cardiovascular disease or cancer," the authors concluded.

"Although the abstract does not specify type 2 diabetes, such information would clarify what I believe is the cause of the excess hazard for diabetics, namely high insulin levels," said Deborah Gordon, MD, a specialist in natural diabetes reversal.

"Elevated insulin is a well known complication for type 2 diabetics and those who progress from type 2 to become type 1 diabetics. Insulin wreaks havoc with our physiology in a variety of ways, many of them mediated by the inflammation occurring in the presence of insulin," said Dr. Gordon who was no involved in the study.

"I counsel diabetics and non-diabetics alike to pursue lifestyle choices that minimize the insulin response. For weight loss, therefore, I believe the jury is in on the superiority of a low-carbohydrate, moderate protein and high fat approach to reducing body fat. And for exercise, while gentle aerobic exercise is a wonderful tool for sustaining body mobility, the best exercise to lower insulin is found in interval work: short (20-60 seconds) bursts of intense exertion, alternating with recovery (10-90 seconds), repeated for 8 cycles, just one or two days a week," she said.

The current study included 4,008 adults 60 years of age and older. At the beginning of the study, researchers collected data on diabetes and major risk factors for death, including social network, diet, physical activity and other lifestyle habits, obesity, high blood pressure, dyslipidemia, and previous cardiovascular disease and cancer.

The research was published August 8 in Diabetes Care, a journal of the American Diabetes Association.

Reviewed by: 
Review Date: 
August 14, 2012
Last Updated:
July 1, 2013