Reducing death from heart disease in diabetes patients
We know that wide blood sugar fluctuations in people with diabetes are correlated with their risk of death from cardiovascular disease, but we do not know exactly why. Now, Dr Christine Rode of the Steno Diabetes Center Copenhagen has received a grant of DKK 1.1 million from the Danish Diabetes Academy to try to find the explanation.
As a PhD student over the next three years, she will conduct two studies, one at the Steno Diabetes Center Copenhagen and one at Hillerød Hospital. She already believes the results obtained will be highly clinically significant for both the treatment and the survival of people with type 1 and type 2 diabetes.
Christine Rode says that previous studies have indicated a link between wide blood sugar fluctuations, low blood sugar (hypoglycaemia) and cardiovascular disease, but that this has not yet been adequately explained. Among patients with type 1 diabetes, sudden unexplained death in young, otherwise healthy people is a known phenomenon. It has been called the ‘dead in bed’ syndrome, as it has been observed in patients who were apparently in good health and had normal blood sugar the evening before. The background to this has not yet been clarified, but the suspicion is that hypoglycaemic episodes at night may cause potentially fatal cardiac arrhythmias, says Christine Rode.
Moreover, little is known about the effect of the blood sugar level on the outcome of balloon angioplasty for a constricted coronary artery, although many diabetes patients have large-vessel disease (ischaemic heart disease).
To explain the link between blood sugar values and cardiovascular disease in people with diabetes, she will therefore conduct two studies: 1) long-term monitoring of blood sugar and heart rhythm by implanting a continuous blood sugar meter together with a loop recorder in patients with type 1 diabetes; and 2) monitoring of blood sugar before, during and after balloon angioplasty in patients with type 2 diabetes.
The participants will be patients with type 1 diabetes (with known hypoglycaemia and at least one diabetic complication) and type 2 diabetics under investigation by coronary angiography (CAG) for heart disease.
Christine Rode MD
Steno Diabetes Center Copenhagen, Faculty of Health and Medical Sciences, University of Copenhagen