MONDAY, March 31 (HealthDay News) -- Diabetics are more than twice as likely to suffer a heart attack, stroke and death from cardiovascular disease, putting them at the same risk level as non-diabetics who had previously suffered a heart attack, Danish researchers report.

The findings, appearing in April 1 issue of Circulation, led one study author to suggest all diabetics talk to their doctors about possibly starting treatments to control cholesterol levels and blood-pressure levels.

"We've talked about 'the lower, the better' for cholesterol and blood pressure to reduce the risk of heart attack," lead author Dr. Tina Ken Schramm, a research fellow at the Gentofte Hospital in Hellerup, Denmark, said in a prepared statement. "Now I think we should be saying the sooner, the better for primary prevention of cardiovascular diseases in diabetics."

The study analyzes patient and national registries for people aged 30 and older living in Denmark in 1997. Researchers found 71,801 people with diabetes and 79,575 who had a previous heart attack, then identified deaths and causes of death over five years.

"The increased risk was observed in people at all ages with either type 1 or type 2 diabetes who were receiving insulin or other drugs to reduce levels of sugar in the blood," Schramm said. "When people with diabetes do have heart attacks, they are twice as likely to die as non-diabetics."

The relative risk, or hazard ratio, of dying from cardiovascular disease was found to be 2.45 times greater for female diabetics compared with 2.62 times greater for women with a prior heart attack. The relative risk of dying from cardiovascular causes was 2.42 times higher in male diabetics; for men who had a prior heart attack the hazard ratio was 2.44.

When looking at heart attack, stroke or death from cardiovascular disease combined, men with diabetes faced a 2.32 higher risk while the risk rate was 2.48 for men who had at least one heart attack. For female diabetics, the combined relative risk was 2.48 while those with a history of myocardial infarction had a hazard ratio of 2.71.

The study did not look at patients on diet-only treatment for diabetes. The researchers also couldn't differentiate between type 1 and type 2 diabetes patients or adjust for common risk factors, including high blood pressure, high cholesterol, obesity, smoking, physical activity and blood glucose levels.

Type 2 diabetes, the most common form of diabetes, develops when the body doesn't make enough insulin and fails to efficiently use what insulin it does produce. In type 1 diabetes, the pancreas makes little or no insulin, requiring the patient to need daily doses of insulin.

More information

The American Diabetes Association has more about diabetes prevention  .

FRIDAY, March 28 (HealthDay News) -- Diabetes, the leading cause of heart disease, stroke, blindness, kidney failure and non-traumatic amputations, can also cause the lungs to deteriorate quicker than they normally do with age, a new study shows.

Although everyone experiences a decline in lung function as they grow older, research published in the April issue of Diabetes Care concluded that the lungs of people with type 2 diabetes deteriorate more quickly than normal.

The Johns Hopkins team that conducted the research, part of a larger investigation known as the Atherosclerosis Risk in Communities (ARIC) study, found in previous research that reduced lung function predicted and preceded the development of type 2 diabetes.

In this latest study, there was an average difference of 6 millimeters more decline per year in forced vital capacity (FVC), a measure of how well the lungs fill with air, said study author Hsin-Chieh Jessica Yeh.

The scientists suggest the accelerated reduction in forced vital capacity (FVC) found in people with diabetes could be the result of high blood sugar levels stiffening lung tissue or fatty tissue in the chest and abdomen restricting the lungs.

The ARIC is a prospective cohort study of 15,792 adults from four U.S. communities. The present analysis, which looked at 1,100 diabetics and 10,162 non-diabetics, was based on three years of follow-up.

"This study confirms the results of five previous studies, which demonstrated lower lung function in diabetic subjects compared with their non-diabetic counterparts," said Dr. Guillermo E. Umpierrez, an associate professor of medicine at Emory University and section head of Diabetes and Endocrinology at the Grady Health System, both in Atlanta. "These studies also demonstrated a higher annual rate of lung function decline in the diabetic compared with the non-diabetic population. Although the information is not novel, this report enhances recognition of the lung as a target of diabetic injury."

Most of the diabetic participants in the current study had type 2 diabetes, so the scientists were not able to look at decreases in lung function among type 1 diabetics, who have to use insulin on a daily basis.

"On the other hand, we found diabetes severity, as indicated by intensity of anti-diabetic treatment, was associated with greater rate of FVC decline. Patients on insulin treatment, alone or with oral medications, had the greatest decline in forced vital capacity compared to their non-diabetic counterparts," Yeh explained.

In an accompanying editorial, Dr. Connie Hsia, of the University of Texas Southwestern Medical Center, cautioned that using inhaled insulin might trigger or exacerbate the pulmonary dysfunction found in people with diabetes.

"However, since none of our study participants were on inhaled insulin, our study did not have direct implications on the use or absorption of inhaled insulin," Yeh said.

Umpierrez pointed out that the use of inhaled insulin needs more study. "The future of inhaled insulin for treatment of diabetes is uncertain; however, some pharmaceutical companies continue to investigate the safety and efficacy of inhaled insulin as an alternative of insulin injections," he noted.

Diminished lung capacity may lead to lower oxygen delivery to all body tissues, he noted, although the drop in lung function among diabetics in this study appears to be small. However, in elderly patients with long-standing diabetes, impairment of lung capacity could worsen the risks of adverse outcomes should the elderly diabetic develop pneumonia, heart failure, volume overload or vascular complications, he added.

"Traditionally, the lung is not treated as a target organ for diabetes complication. Based on the current study, we suggest physicians add lung function on the watch list as they care for their diabetes patients," Yeh said.

More information

For more on diabetes, visit the American Diabetes Association  .