People with type 2 diabetes who have impaired vision or hearing are more likely to experience poor cardiovascular outcomes — including stroke and heart attack — according two a new study published in the Journal of Diabetes Investigation.
Cardiovascular disease — including cardiovascular events like a heart attack or stroke — is by far the leading cause of death in people with diabetes, according to the American Diabetes Association. In fact, about two-thirds of people with type 2 diabetes will die of cardiovascular causes. One recent trend in diabetes research has been identifying factors that could help doctors better predict who is at greatest risk for poor cardiovascular outcomes. For example, a recent study found that reduced grip strength was linked to cardiovascular disease in people with type 2 diabetes. Identifying people with a greater cardiovascular risk could help health care providers find ways to reduce this risk in cooperation with their patients — either through lifestyle measures like cutting back on ultra-processed foods, or by intensifying medical treatment of cardiovascular problems.
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For the latest study, researchers looked at how vision and hearing problems were linked to cardiovascular outcomes in 771,128 people with type 2 diabetes in South Korea. Participants underwent vision and hearing exams in 2009 and were followed until the end of 2018, as noted in a Healio article on the study. The researchers defined visual impairment as any kind of visual disability or vision worse than 20/40 in both eyes, and hearing impairment as any kind of hearing disability or impaired hearing in pure-tone testing in at least one ear. The main outcomes the researchers were interested in were stroke, heart attack, and death from all causes.
Visual, hearing impairments linked to cardiovascular risk
Testing at the beginning of the study found that there were 60,514 participants with a visual impairment (7.8% of all participants), 43,671 with a hearing impairment (5.7%), and 8,720 with both a visual and a hearing impairment (1.1%). All three groups saw a higher risk for stroke, heart attack, and death from all causes. Compared with participants who didn’t have a visual or hearing impairment, those with both kinds of impairment were 29% more likely to have a stroke, 36% more likely to have a heart attack, and 59% more likely to die of all causes. Those with just a visual impairment were 32% more likely to have a stroke, 32% more likely to have a heart attack, and 42% more likely to die of all causes. Those with just a hearing impairment were 13% more likely to have a stroke, 12% more likely to have a heart attack, and 16% more likely to die of all causes.
When they looked at subgroups of participants, the researchers found that people younger than age 65 were especially likely to see an increased risk for stroke, heart attack, and death if they had a visual or hearing impairment. People with diabetic retinopathy (eye disease) also tended to be at higher risk for all three outcomes. Men tended to have a greater risk for heart attack if they had a visual or hearing impairment, while women were at higher risk for death from all causes.
The researchers noted that these findings emphasize the need for vision and hearing screening and care in people with type 2 diabetes — as well as the need for awareness among health care providers that problems with vision and hearing may help predict a higher risk for cardiovascular events and death.
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.”