在现代医学时代，糖尿病仍然是一种危险的疾病

尽管医学进步, having diabetes is still linked to a higher risk of dying from cardiovascular disease, 新的研究表明.

It's long been known that diabetes – a condition that causes blood sugar to rise – increases the risk of death from multiple causes. Past research showed people with diabetes are twice as likely to develop and die from cardiovascular diseases, 包括心脏病, heart failure, 心脏病发作和中风.

But there has been little research looking into diabetes-related mortality among patients getting routine care in the modern era of reducing cardiovascular disease risk. For the 这项新研究发表在周二的《线上电子游戏飞禽走兽》上, researchers from several Veterans Affairs hospitals looked at data from more than 960,000人，其中近330人,000 with diabetes – who received routine primary care from 2002-2014 in the VA Healthcare System.

在分析了每位患者平均8年的数据之后, researchers concluded that while diabetes-related deaths were lower than they were in the 1980s and 1990s, 糖尿病仍然对高死亡率有重大影响. The study found diabetes was associated with a 16 percent increase in dying from any cause and an 18 percent increase in dying from cardiovascular disease.

该研究还表明，糖尿病患者的糖化血红蛋白水平为6到6.9 percent was associated with the lowest levels of death, regardless of how old they were. An A1C test measures a person's average blood glucose control for the past two to three months.

“我认为这是值得注意的，因为它表明年龄本身并不能提供那么多信息. Treatment decisions are a lot more complicated than just basing decisions on someone's age," said Dr. 该研究的主要作者Sridharan Raghavan说.

Raghavan, 他是科罗拉多大学医学院的教授, said that while the exact relationship between A1C levels and mortality rates – and how to use A1C measurements to guide care – remains unclear, 医生应该密切关注糖尿病患者体内的血糖水平.

“即使我们不理解这种关系, it can still tell us something about a person's overall health and risk of mortality," he said.

Dr. David Aguilar, 一位没有参与这项研究的心脏病专家, said the research was limited by being an observational study of mostly male military veterans. But he said the results added to the body of evidence for treating diabetes to lower mortality risk.

"It shows that we're doing better, but it also reminds us of the importance of glucose control. We need to treat people according to guidelines and get their hemoglobin A1C levels to less than 7 percent if they can tolerate that safely,阿吉廖尔说, an associate professor of cardiovascular medicine at the McGovern Medical School at the University of Texas Health Science Center at Houston.

Aguilar, 谁为这项研究写了一篇社论, called for future studies that explore the best strategies to lower cardiovascular risk with newer diabetes medications. Raghavan said more research is needed to pinpoint which patients are best able to lower their mortality risk by maintaining specific A1C levels.

两人都认为，教育是进一步降低风险的关键. 阿吉拉尔指着“用心了解糖尿病," a new initiative launched by the American Diabetes Association and 美国心脏协会 to raise awareness about the link between the two diseases.

根据最近的哈里斯民意调查, only about half of people 45 and older with Type 2 diabetes recognized their risk for a heart attack or stroke. 大约有2600万美国成年人被诊断患有糖尿病, 另有9200万人患有前驱糖尿病, 这种情况会增加患2型糖尿病的风险.

"You can actually mitigate a lot of the mortality risk related to diabetes by controlling cardiovascular risk factors like smoking and cholesterol levels and blood pressure levels,Raghavan说.

Aguilar said doctors need to have frank discussions with patients about the relationship between diabetes and cardiovascular disease, and talk about how exercise and maintaining a healthy weight decreases heart disease risk.

“这不仅仅是血糖的问题，”他说. "Health care providers have to focus on a comprehensive approach and discuss all the different issues and strategies that will empower the patient to lower their risk."

如果你对这个故事有任何问题或评论，请发电子邮件 (电子邮件保护).