People who have diabetes are two to four times more likely to develop heart disease (coronary heart disease, arrhythmia and heart failure) than people without diabetes, but a new study shows that a healthy lifestyle can to a lot to improve their chances.
The researchers derived their statistics from an initiative known as the Swedish Twin Registry, which was established in the 1960s and is the largest twin registry in the world. The main goal of the registry is to examine the effects of certain lifestyle/environmental factors, such as smoking and alcohol consumption, on disease risk. Because twins share a common genetic background and often the same conditions growing up, researchers are able to separate out the environmental factors in determining the health outcomes experienced by the twins during their lives and focus on the lifestyle aspects.
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As might be expected, many studies have been conducted that explore the effects of such environmental/lifestyle factors as alcohol, smoking, exercise and overweight on heart disease. According to the authors of the new study, however, “to the best of our knowledge” theirs is the first to examine how the factors affect the chances of heart disease specifically in people with type 2 diabetes.
The researchers identified 41,463 twin individuals who were over 40 and had no heart disease and followed them up from 1998 to 2014. About 55% were women.
The researchers classified four healthy factors as being “lifestyle-related”: being a nonsmoker, mild or no alcohol use, regular physical activity, and not being overweight. They then divided the subjects into three groups according to how many of these lifestyle-related factors applied to them:
1. Unfavorable (subjects who had no healthy lifestyle factors or just one)
2. Intermediate (any two or three healthy factors)
3. Favorable (all four)
Information on health habits was obtained from survey questions — for example, “has there ever been a period in your life when you drank too much?” The exercise question had seven possible answers: “almost never,” “much less than average,” “less than average,” “average,” “more than average,” “much more than average” and “maximum.”
Healthy lifestyle tied to lower cardiovascular risk
Of all the participants, 5.5% (2,304) had type 2 diabetes at the beginning of the study period. During the study period, about one out of four (22.3%) developed some form of heart disease. The main types of heart disease included such conditions as angina, heart attack (myocardial infarction), coronary thrombosis, irregular or rapid heartbeat and heart failure.
The researchers concluded “that type 2 diabetes is still associated with heart disease, even after fully controlling for genetic and early-life familial environmental factors.” However, after crunching all the numbers, they reported that “being a non-smoker, regular physical activity, no/mild drinking and being nonoverweight were associated with a decreased risk of heart disease.” Compared to an unfavorable lifestyle, persons with an “intermediate” lifestyle showed a 32% decrease in heart disease risk, while persons with a “favorable” lifestyle showed a 56% decrease in risk. The researchers added that “the associations between type 2 diabetes and heart disease did not vary by sex.”
The reasons people with type 2 diabetes suffer from greater rates of heart disease are, the researchers commented, “incompletely understood.” However, they speculated that the reasons a favorable lifestyle lessens the risk of heart disease in people with diabetes include better control of blood sugar, insulin sensitivity, blood pressure, platelet function, lipid profile (cholesterol and triglycerides) and body composition. They summed up their results by writing, “Our findings highlight the need to control type 2 diabetes for the prevention of heart disease. Furthermore, patients with type 2 diabetes should be aware that they must maintain a healthy lifestyle to prevent heart disease.”
Want to learn more about protecting your heart? Read “Be Heart Smart: Know Your Numbers,” “Does Diabetes Hurt Your Heart?” “Fight Off Heart Disease With These Five Heart-Healthy Foods” and “Lower Your Risk of Heart Disease.”
Living with type 2 diabetes? Check out our free type 2 e-course!