In the general population, around 9% of people have diabetes. A recent study has found that this figures rises to 30% in patients with coronary heart disease, meaning heart patients are three times more likely to have diabetes than the general population.

The study, which was published in the European Journal of Preventive Cardiology, analysed more than 30,000 patients from the CLARIFY registry. The patients were enrolled in 2009 to 2010 and had annual follow ups for five years.

Wide geographical variation across the sample 

All the patients had chronic coronary syndromes and spanned across 45 countries in Europe, Asia, America, the Middle East, Australia, and Africa. The researchers found wide geographical variation, with 60% of heart disease patients in Gulf countries having diabetes compared to 20% in Europe.

The author of the study, Dr. Emmanuelle Vidal-Petiot of Bichat-Claude Bernard Hospital, Paris, said: “Obesity and lack of exercise are common risk factors for both diabetes and heart disease and our results highlight the urgent need to improve nutrition and raise activity levels globally.

“Countries worst affected by diabetes are also at the epicentre of the obesity epidemic, which can be in part attributed to urbanisation and associated changes in physical activity and food intake.”

The researchers compared the likelihood of adverse clinical outcomes in heart patients with diabetes compared to those without diabetes. They adjusted the analyses for multiple factors that could influence the relationship including age, sex, smoking status, body mass index, blood pressure, medications, and other conditions.

Adverse clinical outcomes occurred more frequently among heart patients with diabetes than those without

The results found that poor outcomes occurred much more frequently in those with diabetes. For example, among patients with stable coronary heart disease, those with diabetes had a 38% higher rate of death during the five-year follow-up. They also had a 28% higher risk of the combined outcome of heart attack, stroke, or death from a cardiovascular cause.

Dr. Vidal-Petiot said: “Diabetes was linked with worse outcomes even in areas with the lowest prevalence. In Europe, for instance, diabetes was linked with a 29% greater risk of the combined outcome of heart attack, stroke, or cardiovascular death. This indicates that management of these very high-risk patients with heart disease and diabetes should be improved. Each country needs to identify these patients and provide tailored educational and prevention programmes.

“The importance of healthy eating and living cannot be overemphasised. Everyone can lower their chances of developing diabetes with weight control and exercise, and early detection is needed so that blood sugar can be controlled. Those with heart disease and diabetes also need an active lifestyle and a good diet to protect their health. Avoiding smoking is crucial, as is controlling blood pressure and cholesterol levels.”