Delayed Onset of Type 2 Diabetes by Six Years or More Significantly Reduces Risk of Cardiovascular Disease and Microvascular Disease

Analysis of 30-year follow up of more than 500 adults in China examines the extent of increased cardiovascular risk can be attributed to diabetes

News provided by

American Diabetes Association

Jun 09, 2019, 13:00 ET

SAN FRANCISCO, June 9, 2019 /PRNewswire/ -- People with impaired glucose tolerance (IGT) may significantly lower their risk of cardiovascular disease (CVD) and microvascular disease by delaying the onset of type 2 diabetes (T2D) by six years or more, or by returning to a normal level of glucose tolerance altogether, according to the study, "Early Progression to Diabetes or Regression to Normal Glucose Tolerance Among People with Impaired Glucose Tolerance Affects Long-Term Outcomes: Thirty-Year Follow-Up of Da Qing Diabetes Prevention Study," presented today at the American Diabetes Association's® (ADA's) 79th Scientific Sessions® at the Moscone Center in San Francisco.

People with IGT have a much higher likelihood of developing T2D and a higher risk of developing CVD and microvascular disease compared to those with normal glucose tolerance. The Da Qing Diabetes Prevention Study (DQDPS) showed that 90% of IGT participants in the non-intervention group had developed diabetes over a 20-year period, however the extent of increased risk that can be directly attributed to the onset of diabetes has been unclear.

To assess this risk, researchers conducted a secondary analysis of the DQDPS. The original study enrolled 540 adults in China with IGT who were randomly assigned to participate in a lifestyle intervention (diet or exercise, or both) for six years. At the end of the study, participants were evaluated to determine who had developed diabetes, regressed to normal glucose tolerance or remained with IGT. In 2016, 30 years after the start of the study, researchers conducted a follow-up study to assess the number and proportion of participants who had developed CVD (defined as non-fatal or fatal stroke, myocardial infarction or heart failure) and microvascular disease (defined as the first occurrence of severe retinopathy, nephropathy or neuropathy).

The results of the analysis found among the 252 adults who had developed diabetes, 65.6% developed CVD and 44.3% developed microvascular disease; among the 114 who remained with IGT, 50.6% developed CVD and 31.2% developed microvascular disease; and among the 174 who reverted to normal glucose tolerance, 46.1% developed CVD and 23.1% developed microvascular disease. Overall, those with IGT who developed diabetes had a 69% higher incidence of CVD and a 150% higher incidence of microvascular disease.

As a result, researchers concluded that delaying the onset of diabetes in people with IGT by six years or more resulted in lower rates of complications and reduces the development of both CVD and microvascular disease.

"We know people with impaired glucose tolerance are at high risk for developing diabetes and other complications," said study author Guangwei Li, MD, honorary director of the International Medical Center at the China-Japan Friendship Hospital; and director of the center of endocrinology and cardiovascular disease at the National Center of Cardiology at Fuwai Hospital, Chinese Academy of Medical Sciences. "Our study clearly shows that reversing or delaying the onset of diabetes in people with IGT by six years or more significantly lowers their risk for developing long-term complications such as CVD and microvascular disease. Essentially, the longer progression to diabetes can be delayed, the fewer the complications."

To speak with Dr. Li, please contact the ADA Press Office on-site at San Francisco's Moscone Convention Center on June 7-11, by phone at 415-978-3606 or by email at [email protected].

The American Diabetes Association's 79th Scientific Sessions, the world's largest scientific meeting focused on diabetes research, prevention and care, will be held June 7-11, 2019, at the Moscone Center in San Francisco, California. Nearly 15,000 leading physicians, scientists, health care professionals and industry representatives from around the world are expected to convene at the Scientific Sessions to unveil cutting-edge research, treatment recommendations and advances toward a cure for diabetes. During the five-day meeting, attendees will receive exclusive access to more than 850 presentations and 2,000 original research presentations, participate in provocative and engaging exchanges with leading diabetes experts, and can earn Continuing Medical Education (CME) or Continuing Education (CE) credits for educational sessions. The program is grouped into eight thematic areas: Acute and Chronic Complications; Behavioral Medicine, Clinical Nutrition, Education and Exercise; Clinical Diabetes/Therapeutics; Epidemiology/Genetics; Immunology/Transplantation; Insulin Action/Molecular Metabolism; Integrated Physiology/Obesity; and Islet Biology/Insulin Secretion. Gretchen Youssef, MS, RDN, CDE, President of Health Care and Education, will deliver her address, "It's All About Access!," on Saturday, June 8, and Louis H. Philipson, MD, PhD, FACP, President of Medicine and Science, will deliver his lecture, "Precision Medicine—Addressing the Many Faces of Diabetes," on Sunday, June 9. Join the Scientific Sessions conversation on social media using #ADA2019.

About the American Diabetes Association
Every day more than 4,000 people are newly diagnosed with diabetes in America. Nearly 115 million Americans have diabetes or prediabetes and are striving to manage their lives while living with the disease. The American Diabetes Association (ADA) is the nation's leading voluntary health organization fighting to bend the curve on the diabetes epidemic and help people living with diabetes thrive. For nearly 80 years the ADA has been driving discovery and research to treat, manage and prevent diabetes, while working relentlessly for a cure. We help people with diabetes thrive by fighting for their rights and developing programs, advocacy and education designed to improve their quality of life. Diabetes has brought us together. What we do next will make us Connected for Life. To learn more or to get involved, visit us at diabetes.org or call 1-800-DIABETES (1-800-342-2383). Information is available in English and Spanish. Join the fight with us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn).

153-OR Early Progression to Diabetes or Regression to Normal Glucose Tolerance Among People with Impaired Glucose Tolerance Affects Long-Term Outcomes: Thirty-Year Follow-Up of Da Qing Diabetes Prevention Study

News Briefing: Prevention of Type 2 Diabetes, Saturday, June 8, 11:45 a.m. - 12:45 p.m. PT

Session Type: Oral Presentations
Location: W-2022 (West, Level 2)
Session Time: Sunday, June 9, 2019, 8:00 a.m. - 10:00 a.m.

YANYAN CHEN, PING ZHANG, JINPING WANG, QIUHONG GONG, YALI AN, EDWARD GREGG, PETER H. BENNETT, GUANGWEI LI, Beijing, China, Atlanta, GA, Daqing, China, Phoenix, AZ

Background: People with IGT, a form of prediabetes, have a much higher likelihood of developing diabetes and a higher risk of developing CVD and microvascular disease compared to those with normal glucose tolerance; however, the extent of increased risk that can be directly attributable to the onset of diabetes is unclear.

Methods: Researchers conducted a secondary analysis of the 1986 Da Qing Diabetes Prevention Study (DQDPS), which identified 540 Chinese adults with IGT who participated in a lifestyle intervention trial for six years. At the end of the trial, participants were assessed to determine the numbers and proportion who had developed diabetes, regressed to normal glucose tolerance or remained with IGT. In 2016, 30 years after the start of the trial, researchers conducted a follow up study to assess the number and proportion who had developed CVD (defined as non-fatal or fatal stroke, myocardial infarction or heart failure) and microvascular disease (defined as the first occurrence of severe retinopathy, nephropathy or neuropathy).

Results: Among the 252 adults who had developed diabetes, 65.6% developed CVD and 44.3% developed microvascular disease; among the 114 who remained with IGT 50.6% developed CVD and 31.2% developed microvascular disease; and among the 174 who reverted to normal glucose tolerance, 46.1% developed CVD and 23.1% developed microvascular disease. Overall, those with IGT who developed diabetes had a 69% higher incidence of CVD and a 150% higher incidence of microvascular disease.

Conclusions: Delaying the onset of diabetes in people with IGT by six years or more results in lower rates of complications and reduces the development of both CVD and microvascular disease.

Author Disclosures: Y.Chen: None. P.Zhang: None. J.Wang: None. Q.Gong: None. Y.An: None. E.Gregg: None. P.H.Bennett: None. G.Li: None.