The Role of Lifestyle Change for Prevention of Cardiovascular Disease in Diabetes

Abstract

The burden of cardiovascular disease (CVD) is disproportionately greater in those with diabetes than in the general population, including higher rates of hospitalization, stroke, myocardial infarction, and mortality. Health-promoting lifestyle factors reduce both diabetes and CVD in healthy individuals; however, the efficacy of these strategies for CVD reduction in people with preexisting diabetes is unclear. In this review, we describe the most recent evidence (2013-2014) surrounding the effects of lifestyle changes on CVD outcomes in those with diabetes, and we contextualize the evidence against a backdrop of earlier key findings. Two major randomized controlled trials were identified, providing opposing conclusions about the role of lifestyle factors on CVD events in those with diabetes. Other recent prospective observational analyses support associations of physical activity and reduced CVD risk in diabetes. Limitations across studies include the use of self-report for measurement of lifestyle or lifestyle change, the length of follow-up needed to measure CVD outcomes, and the role of participants' medications on associations of lifestyle factors and CVD outcomes. Equivocal findings from the two randomized controlled trials support the need for additional research to identify the specific lifestyle factors that reduce CVD mortality and macrovascular complications in populations with diabetes.

In Patients with Coronary Artery Disease and Type 2 Diabetes, SIRT1 Expression in Circulating Mononuclear Cells Is Associated with Levels of Inflammatory Cytokines but Not with Coronary Lesions

“…Macrovascular complications are common in patients with T2DM who then present accelerated atherosclerotic changes in vessels [ 22 ]. Growing evidence suggests that SIRT1 can be regarded as a new therapeutic target to prevent or reverse such complications [ 23 – 25 ].…”

Diabetes Type 2 and Physical Activity Program: Potential Application of Risk-Engine UKPDS Score in Out-Patient Context

“…Correct lifestyle behaviors are widely promoted to reduce both diabetes and cardiovascular disease (CVD) in healthy individuals [3]. There is some evidence supporting the effects of lifestyle changes on CVD outcomes, even though some limitations such as self-reporting life style measurements are often recognized [4,5].…”

The Effects of a 12 Week Nutrition and Physical Activity Intervention Program on Mexican Americans Residing in the Lower Rio Grande Valley, TX

“…however, in those individuals who have diabetes, lifestyle changes have a tremendous impact on the onset of cardiovascular disease ((National Center for Health Statistics, 2015;Staimez, Weber, & Gregg, 2014;World Health Organization, 2012;Hoyert, 2012).…”

“…These and the physical environment, such as access to healthy foods and safe walking areas, play a key role in its prevalence (Pasala, Rao, & Sridhar, 2010). In those individuals with diabetes, several interventions have yielded positive outcomes such as weight loss, which in turn led to less need for medication, improved lipid levels and glycemic control (Staimez, Weber, & Gregg, 2014;Rejeski, Bertoni, Bray, Evans, & Gregg, 2012;Koivula, Tornberg, & Franks, 2013).…”

“…Those that have better controlled diabetes, have more positive outcomes such as a decrease in morbidity and mortality and macrovascular complications. The ability to reduce complications, such as stroke and myocardial infarction, as a result of diabetes, are of particular interest to researchers and are described below (Staimez, Weber, & Gregg, 2014).…”