Type 2 diabetes may increase risk of extracranial large artery disease: Lancet

A recent comprehensive study published in The Lancet Regional Health - Europe identified a significant decline in the incidence of peripheral arterial complications among the individuals with type 2 diabetes in Sweden, although the challenges persist with increasing rates of aortic aneurysms. The findings that were sourced from the Swedish National Diabetes Register spanned for nearly two decades offer an in-depth comparison between diabetic patients and the general population.

The research included a robust cohort of a total of 655,250 individuals who were diagnosed with type 2 diabetes, with an average age of 64.2 years where 43.8% of them being women. The outcomes in this extensive study examined the extracranial large artery disease, aortic aneurysm, aortic dissection, lower extremity arterial disease and diabetic foot disease. This research utilized standardized incidence rates and Cox regression analyses to track and interpret the data collected.

The results from this study highlight a downward trend in the incidence rate per 100,000 person-years for extracranial large artery disease nearly halved from 170.0 to 84.9 and lower extremity arterial disease decreased significantly from 338.8 to 190.8. The diabetic foot disease also faced a decline from 309.8 to 226.8. The aortic aneurysms saw an increase in incidence rates from 40.6 to 69.2 per 100,000 person-years that signalled a need for increased monitoring and intervention strategies for this particular complication.

This study underlined the role of controlled health metrics in reducing the risk of complications. High baseline hemoglobin A1c (HbA1c) levels, systolic blood pressure, smoking status and lipid levels were independently related with adverse outcomes across the board. Achieving target levels for these risk factors notably reduced the incidence of complications. For instance, the risk of extracranial large artery disease and lower extremity artery disease escalated stepwise with each risk factor that was not within target levels.

In a comparative analysis, the hazard ratios adjusted for individuals with type 2 diabetes showed varying levels of risk when compared to matched controls without diabetes. The individuals with diabetes had a significantly higher risk for extracranial large artery disease and lower extremity artery disease, but, a lower risk for aortic aneurysm and aortic dissection. These insights improve targeted interventions and continued research to improve quality of life for the individuals with type 2 diabetes.

Source:

Rawshani, A., Eliasson, B., Boren, J., Sattar, N., Bhatt, D., El-Khalili, L., Nordanstig, J., Avdic, T., Beckman, J. A., Gerstein, H. C., McGuire, D. K., Omerovic, E., & Rawshani, A. (2024). Non-coronary peripheral arterial complications in people with type 2 diabetes: a Swedish retrospective cohort study. In The Lancet Regional Health - Europe (Vol. 39, p. 100888). Elsevier BV. https://doi.org/10.1016/j.lanepe.2024.100888