BP and weight more important than BG for T2D vascular health

[Eddy Edson]

Genetic Evidence Strongly Supports Managing Weight and Blood Pressure in Addition to Glycemic Control in Preventing Vascular Complications in People With Type 2 Diabetes

OBJECTIVE. To investigate the causal association of type 2 diabetes and its components with risk of vascular complications independent of shared risk factors ob

diabetesjournals.org

RESULTS
Univariable MR analysis showed that type 2 diabetes was associated with 9 of 15 outcomes; BMI and systolic blood pressure were associated with 13 and 15 of 18 vascular outcomes, respectively; and fasting insulin was associated with 4 and fasting glucose with 2. No robust association was found for HbA1c instruments. With adjustment for correlated traits in the multivariable test, BMI and systolic blood pressure, consistent causal effects were maintained, while five associations with type 2 diabetes (chronic kidney disease, ischemic heart disease, heart failure, subarachnoid hemorrhage, and intracerebral hemorrhage) were attenuated to null.

CONCLUSIONS
Our findings add strong evidence to support the importance of BMI and systolic blood pressure in the development of vascular complications in people with type 2 diabetes. Such findings strongly support the need for better weight and blood pressure management in type 2 diabetes, independent of glucose lowering, to limit important complications.




As presented in this graphic, BP most important (biggest independent effect on the most vascular conditions), followed by BMI, followed by fasting insulin/glucose. No indpendent effect was found for HbA1c.

Would be interesting to see where lipids fit into this picture.

 

[Martin.A]

At the most recent Managing T2 session I attended (session 3 of 6) at our medical centre the GPs presented a chart showing that where people with CVD had another medical condition, diabetes was the most common one.

 

[everydayupsanddowns]

Intrigued by how this interconnects with the increased CVD and CHD risk in people with T1, which seems to be thought to be related to BG - and why BG might be implicated in one form of diabetes, but exonerated in a other

 

[Eddy Edson]

Intrigued by how this interconnects with the increased CVD and CHD risk in people with T1, which seems to be thought to be related to BG - and why BG might be implicated in one form of diabetes, but exonerated in a other

Well to be fair, it's not exonerated, just less of an indept risk factor for some vascular nasties. It's still an indept factor for eg stroke & MI, I guess two of the biggies. But it's not the be all & end all for people with T2D - BMI and BP are also indept factors for these, and for more besides.

 

[Eddy Edson]

Well to be fair, it's not exonerated, just less of an indept risk factor for some vascular nasties. It's still an indept factor for eg stroke & MI, I guess two of the biggies. But it's not the be all & end all for people with T2D - BMI and BP are also indept factors for these, and for more besides.

CKD is an interesting one ...

 

[everydayupsanddowns]

CKD is an interesting one ...

The relationship between CKD and BP gets mentioned to me in T1 clinics. Because of the stresses BP can put on fine blood vessels I think?