Type 2 diabetes (T2D) is a metabolic disorder of insulin resistance — a reduced sensitivity to the action of insulin — which leads to high blood sugar, or hyperglycemia. Approximately 12% of American adults have T2D, and more than one-third of Americans have prediabetes, a precursor to T2D. This is a major public health concern, as T2D dramatically increases risk for heart disease, including heart attacks, atrial fibrillation, and heart failure.
The development and progression of T2D is affected by many factors. Some, such as a person’s race/ethnicity, age, and gender cannot be modified. Others, including body weight, exercise, and diet can be changed.
Can lifestyle changes help reduce heart disease risk if you have diabetes?
In 2010, the American Heart Association (AHA) published “Life’s Simple 7,” which they defined as “seven risk factors that people can improve through lifestyle changes to help achieve ideal cardiovascular health.” The Simple 7 touched on smoking status, physical activity, ideal body weight, intake of fresh fruits and vegetables, blood sugar, cholesterol levels, and blood pressure.
Subsequent studies found that people in optimal ranges for each of these factors had lower risks of heart disease compared to people in poor ranges. But given the significant increase in heart disease risk in those with T2D, it was not clear if the impact of these modifiable factors would hold true for the T2D population.
Recent study suggests lifestyle changes do benefit T2D and prediabetes
A recent study published in JAMA Cardiology looked at whether the ideal cardiovascular (CV) metrics covered in Life’s Simple 7 translate into improved CV health for those with T2D or prediabetes. The results were exciting, and consistent with other large population-based studies. Patients who had five or more ideal CV measures had no excess of CV events compared with people with normal blood sugar levels. CV events measured in the study included death, heart attack, stroke, and heart failure. Each additional ideal health metric was associated with an additional 18% drop in CV event risk for people with T2D, and an additional 15% drop for those with prediabetes.