Word: heart
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Dates: during 2000-2009
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...Wackers stresses, however, that these findings do nothing to diminish the very real risk of heart disease in diabetics. A 1998 Finnish study documented that diabetes patients who had not suffered a heart attack had the same poor health profile as those who had - findings that prompted the American Diabetes Association to recommend heart-disease screening for all diabetes patients with two or more additional risk factors for heart disease, such as high cholesterol or hypertension, even in the absence of symptoms. "That study really changed the field," says Wackers, "and told us we cannot miss the risk of heart...
...With his latest findings, however, Wackers thinks the ADA guidelines are ready for a revision. Heart screenings may not be as important as basic primary prevention strategies, such as ensuring that diabetes patients control their weight, cholesterol and blood pressure, and stop smoking. He argues that if the rate of heart problems is indeed declining in diabetes patients because they are being adequately treated for the risk factors for heart disease, then the stress test recommendation becomes redundant - and expensive...
...John Buse, a DIAD investigator and immediate past president of the American Diabetes Association, agrees that the screening should be limited. "We probably should not be doing stress tests in people without heart symptoms," he says. "But doctors need to make sure to ask questions of their patients about any possible symptoms they may be having of heart trouble...
...Some experts note that while the rate of heart disease in the people without diabetes may be improving - due in part to increasing efforts to lower patients' cholesterol and blood pressure, among other risk factors - diabetes patients who have already had heart attacks appear not to be benefiting as much from the same preventive measures, and continue to suffer and die from higher-than-average rates of heart problems...
...decrease the bad outcomes in people who get heart disease within the setting of diabetes?" says Dr. David Nathan, director of the diabetes center at Massachusetts General Hospital. "There is just no clear answer to that...