Conference Coverage

Vitality predicts T2DM major cardiovascular event risk


AT EASD 2017

Assessing type 2 diabetes mellitus patients’ sense of vitality may help predict whether they will experience a major cardiovascular event,according to the results of a primary care study.

Seldom feeling “full of pep” or not having “a lot of energy” was associated with an increased risk of a major cardiovascular event (MACE) in middle-aged (55-66 years) adults with T2DM, Marta Vergara, MD, reported at the annual meeting of the European Association for the Study of Diabetes.

Dr. Marta Vergara of Linköping University (Sweden)

Dr. Marta Vergara

In fact, there was a 32% and a 44% increased risk of MACE in those who answered that they rarely felt full of pep or rarely had a lot of energy, she said, with respective hazard ratios (HRs) of 1.32 (P = .003 ) and 1.44 (P less than .0001). The risk remained after adjustment for multiple confounding factors.

“It’s well known that patients with type 2 diabetes have a high risk for developing cardiovascular disease, and it is the main cause of death,” said Dr. Vergara of Linköping (Sweden) University.

While several risk factors for cardiovascular disease are known and widely monitored for in clinical practice worldwide, including psychological aspects such as mental stress, ways to identify patients earlier are needed.

“We need more clinically useful and easy-to-manage measurement instruments,” Dr. Vergara said.

Using data from the ongoing Cardiovascular Risk Factors in Patients With Diabetes – a Prospective Study in Primary Care (CARDIPP), Dr. Vergara and colleagues identified two questions used in the 36-Item Short Form (SF-36) that might fit the bill:

  • ”How much time during the past 4 weeks did you feel full of pep?”
  • “How much time during the past 4 weeks did you have a lot of energy?”

In addition to completing the full SF-36 at recruitment, all patients enrolled in CARDIPP underwent thorough assessment of baseline cardiovascular risk. This included asking about their duration of diabetes and smoking history, taking glycemic and anthropometric readings, and recording their systolic blood pressure. Pulse wave velocity was also used to assess patients’ carotid-femoral artery stiffness.

Over a follow-up period of 7 years, 59 (7.8%) of 761 men and women aged 55-66 years developed ischemic heart disease or had a stroke and needed hospital treatment or died.

“Our data support the use of questions about sense of vitality in order to add prognostic information about subsequent risk of MACE independently of traditional risk markers, such as diabetes duration, age, HbA1c, gender, smoking, systolic blood pressure, and carotid-femoral pulse wave velocity and sagittal abdominal diameter,” Dr. Vergara said.

“We suggest that not feeling full of pep and not having a lot of energy could be used as risk markers for MACE in patients with type 2 diabetes.” These are two easy questions that could be asked as part of the risk assessment process in primary care, she suggested. “Other questions from the SF-36, such as feeling tired or worn out, were not independent markers of MACE,” Dr. Vergara said.

She said she had no relevant financial disclosures.

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