Diabetes and heart risk. My goodness do we hear a lot about that. And for good reason: people with diabetes are 2-4 times more likely to develop atherosclerosis (hardening of the blood vessels) and five times more likely to have a stroke than people without diabetes, according to the ADA. Yipes! And then there’s the uproar of late about diabetes drugs that possibly increase the risk of heart attack (although the evidence on Avandia apparently wasn’t conclusive enough to pull the drug off the market). Some of us are worried that the current climate of fear may be creating some very negative consequences:
1) As the Washington Post points out: “The concern now is that worries over heart attack have led many people to leave their diabetes untreated, abandoning their medication without picking up other drugs or other means of controlling the disease.” Lets not forget that untreated diabetes causes the biggest risk — and not only of heart attack, but many other nasty complications as well.
2) Many leaders in the D-patient community are concerned that tightening FDA regulations will end up serving to quash innovation and slow development of many potentially positive new treatments. (More about that HERE.)
But what I
really wanted to highlight today was a new heart risk test on the market from a New Jersey-based company called Synvista Therapeutics. They’ve developed a sophisticated genetic test that may be useful for those who REALLY WANT OR NEED TO KNOW how high their cardiovascular risk factors stand.
The test determines whether you are producing a particular variant of a blood protein called haptoglobin (Hp for short) that may increase your risk of heart disease. “Since this test determines which diabetic patients display the highest levels of oxidative stress (Hp 2-2 individuals) it can also be used to identify the subset of diabetics who will benefit most from potent anti-oxidizing agents,” the company’s website explains. In other words, the test could suggest anti-oxidant therapy as an intervention in case you turn up to be in the highest risk class for cardiovascular disease.
You can read details about the haptoglobin test in the latest issue of the excellent patient newsletter diaTribe. Note that the test costs $325, and is so new that it is not yet reimbursed by most insurance companies. In fact, many doctors may not even know about it yet.
Nevertheless, diaTribe Editor Kelly Close actually took the new test for a “test drive” herself, following this simple procedure:
- Get a blood draw prescription from your healthcare provider.
- Have your blood drawn at your local lab.
- Have your lab send the sample sent to the ARUP lab in Salt Lake City with a request for a Haptoglobin (HP) Genotyping PCR – code number 0040116
- The results will be sent to your physician in 2-7 days.
- Work with your physician and healthcare team to develop an appropriate plan of action based on the results.
She points out that you might be able to secure insurance coverage “with the right letter from your doctor” — if you have special reason to be very worried about your cardiovascular risk. That would of course include folks whose glycemic control has been pretty poor for a while. Taking the test “may help you better manage your risk or may help your motivation to do so,” she notes.
Or, another way to go about it would be to enter diaTribe’s current promotion to win a free haptoglobin test, by filling out a survey form HERE. Weird — the stuff we consider prizes as diabetics, ay? 
Anyway, keep your eye on your heart health. For my part, I’m feeling very O-L-D, as my endo started me on statins after my last checkup. More about that here soon.
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Sorry, Amy, but statins are scary things. I’ve heard too many stories about them causing Alzheimer’s and related conditions. I’m firmly of the belief that for most of us, diet and exercise can be used to manage our cholesterol levels. Not to mention that the new “goals” (over 60 HDL/under 70 LDL) are scarily close to problem levels (under 50 LDL is extremely dangerous, and apparently higher HDL does not protect us, since for some reason our HDL is defective)…
I strictly follow a low-carbo. high fat, medium protein diet to control my type 1 diabetes. I exercise regularly (well, except during winter) and am in excellent health. My blood sugars average 89 mg/dL so far this month.
When everyone on your father’s side of the family died of cardiovascular complications of diabetes, you
a) don’t need the test to know you are at risk
b) toss down any pill that could help prevent it.
I have to echo Kathleen here (almost word for word).
When most everyone on both sides of the family died of cardiovascular disease (whether they had diabetes or not), you
a) don’t need the test to know you are at risk
b) toss down any pill that could help prevent it.
The thing with statins causing Alzheimers reminds me of the (irrational) scare that MMR vaccinations cause autism. I´ve seen a couple of studies on statins and diabetes lately with strong outcomes and some doctors are advocating that every diabetic over the age of 25 should be on them. They definetely provide strong cardiovascular protection, which is now the major mortality risk for diabetics. I would suggest that as good BG control becomes more prevalent in the future combined with better treatment methods the relative importance of the classic complications – eyes, kidneys, feet, nerves- will decline. As life expectancy of PWD increases further cardiovascular prevention (and treatment) will become key. Statins therefore (in the absence of negative evidence) will be a key strategic tool to prolong health until a cure is found.
[...] Speaking of Heart Risk Diabetes and heart risk. My goodness do we hear a lot about that. And for good reason: people with diabetes are 2-4 times more likely to develop atherosclerosis (hardening of the blood vessels). Mail this post [...]
Seems to me it’d make sense to pony up for the Haptoglobin (Hp) Genotype test, and if there’s a strong indicator present for cv disease, then go for the statins. (Of course the decision also depends on how out of range one’s lipid profile is; and how much you’ve already tried diet & exercise to get better results.)
I was on Lipitor for about two years before stopping a few years ago while trying to get pregnant. I didn’t get pregnant (sob!) but I also haven’t gone back on statins. While on them, my numbers were significantly better, both HDL & LDL — we were aiming at raising HDL — and I had no side effects. Now I’m trying to get in range (for my endo that’s under 100 for LDL, not the scary below 70 mentioned above) by cutting down on hard cheese & eggs (I don’t eat meat).
What’s that about “higher HDL does not protect us since for some reason our HDL is defective”? hadn’t heard that one.
Yes, statins are serious drugs and there’s no way in hell I would take them without doing some in-depth research of my own. I am not sure of the link between type 1 diabetes itself and abnormal blood lipids. I have been told about 25 different things by my endocrinologist, my professors, and 2 cardiologists. I would grill my doctor about a statin prescription and demand to see some medical literature and hard evidence on the subject before blindly filling the prescription. It’s your life, you’d better know what you’re putting into your body, and why.