A diabetes não controlada mata e incapacita. Aqui ao lado em Espanha registos da região de valência dizem-nos quanto

O risco relativo de mortalidade por todas as causas e hospitalização POR DAC e AVC, comparando pessoas com diabetes controlada e não controlada foi 1,29 (IC 95 1,08,155), 1,38 (IC 95 1,20,1,59) e 1,05 (IC 95 0,91, 1,21), respetivamente. O risco populacional atribuível (RAP) associado ao não controlo da diabetes foi de 13,6% (IC 95%; 4,0-23,9) para mortalidade por todas as causas, 17,9% (IC 95%; 10,5-25,2) para CHD e 2,7% (IC 95%; – 5,5-10,8) para hospitalização por acidente vascular cerebral. Foram estas as conclusões de um estudo recente publicado no BMC Cardiovasc Disord. 2018 Sep 4;18(1):180.

Mortality and cardiovascular disease burden of uncontrolled diabetes in a registry-based cohort: the ESCARVAL-risk study.

Navarro-Pérez J(1)(2), Orozco-Beltran D(3), Gil-Guillen V(3), Pallares V(4), Valls F(5), Fernandez A(6), Perez-Navarro AM(6), Sanchis C(7), Dominguez-Lucas A(1), Martin-Moreno JM(8), Redon J(9)(10)(11), Tellez-Plaza M(1)(12); ESCARVAL STUDY GROUP.

BACKGROUND: Despite the epidemiological evidence about the relationship between diabetes, mortality and cardiovascular disease, information about the population  impact of uncontrolled diabetes is scarce. We aimed to estimate the attributable  risk associated with HbA1c levels for all-cause mortality and cardiovascular hospitalization.

METHODS: Prospective study of subjects with diabetes mellitus using electronic health records from the universal public health system in the Valencian Community, Spain 2008-2012. We included 19,140 men and women aged 30 years or older with diabetes who underwent routine health examinations in primary care.

RESULTS: A total of 11,003 (57%) patients had uncontrolled diabetes defined as HbA1c ≥6.5%, and, among those, 5325 participants had HbA1c ≥7.5%. During an average follow-up time of 3.3 years, 499 deaths, 912 hospitalizations for coronary heart disease (CHD) and 786 hospitalizations for stroke were recorded. We observed a linear and increasingly positive dose-response of HbA1c levels and  CHD hospitalization. The relative risk for all-cause mortality and CHD and stroke hospitalization comparing patients with and without uncontrolled diabetes was 1.29 (95 CI 1.08,1.55), 1.38 (95 CI 1.20,1.59) and 1.05 (95 CI 0.91, 1.21), respectively. The population attributable risk (PAR) associated with uncontrolled diabetes was 13.6% (95% CI; 4.0-23.9) for all-cause mortality, 17.9% (95% CI; 10.5-25.2) for CHD and 2.7% (95% CI; - 5.5-10.8) for stroke hospitalization.

CONCLUSIONS: In a large general-practice cohort of patients with diabetes, uncontrolled glucose levels were associated with a substantial mortality and cardiovascular disease burden.

BMC Cardiovasc Disord. 2018 Sep 4;18(1):180.