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Taking diabetes to heart

Taking diabetes to heart

IPSSA, the International Plant Sterols and Stanols Association, endorses the International Diabetes Federation (IDF) survey “Taking Diabetes to Heart”.

The IDF in collaboration with Novo Nordisk has launched “Taking Diabetes to Heart”, a multi-country online survey aiming to raise awareness and knowledge of cardiovascular disease (CVD) in people with type 2 diabetes mellitus (T2DM). The results of this survey will support the development of tools, educational resources and policies designed to reduce the burden of CVD amongst people living with T2DM. The outcome of this survey will further help to define actions to further promote knowledge and awareness of CVD and to improve health outcomes of people living with T2DM.

Results :

https://idf.org/our-activities/care-prevention/cardiovascular-disease/taking-diabetes-to-heart.html

Worldwide, the prevalence of T2DM is steadily increasing due to ageing populations and unhealthy lifestyles. It is expected that by 2030, 1 in 10 adults will have T2DM (1). Diabetes itself is an independent risk factor for CVD and individuals with T2DM have on average a 2-fold increase in CVD risk compared to those without diabetes (2, 3).

Next to keeping hyperglycaemia (blood glucose) under control, also dyslipidaemia characterised by elevated blood triglycerides (TG), low high-density lipoprotein cholesterol and elevated low-density lipoprotein cholesterol (LDL-C) concentrations should be improved. Lowering LDL-C is the primary target of blood lipid lowering therapy in T2DM (3).

Diet and lifestyle management plays a key role and should be recommended to all people with or at risk of T2DM. Amongst dietary ways to control blood lipids, foods with added plant sterols or stanols have been shown to lower LDL-C concentrations in individuals with T2DM comparably as achieved in hypercholesterolaemic, but otherwise healthy people (4,5). A meta-analysis of randomised, placebo-controlled studies with people diagnosed with T2DM concluded that plant sterols and stanols at intakes of 1.6-3.0 g/d significantly lowered LDL-C concentrations by 0.31 mmol/L or about 10% (4).

Therefore, the LDL-C lowering benefit of foods and supplements with added plant sterols and stanols can be considered of clinical relevance and may help to further reduce the risk of CVD in T2DM as part of a healthy diet and lifestyle approach.

Several dietary guidelines tailored towards diabetes already refer or explicitly mention plant sterols/stanols as part of the diet and lifestyle intervention, such as the guidelines of the American Diabetes Association and of Diabetes UK (6,7).

References

  1. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010 Jan;87(1):4-14.
  2. Sattar N. Revisiting the links between glycaemia, diabetes and cardiovascular disease. Diabetologia 2013 Apr;56(4):686-95.
  3. Catapano AL, Graham I, De Backer G, Wiklund O, Chapman MJ, Drexel H, et al. 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias. Eur Heart J. 2016;37(39):2999-3058.
  4. Baker WL, Baker EL, Coleman CI. The effect of plant sterols or stanols on lipid parameters in patients with type 2 diabetes: a meta-analysis. Diabetes Res Clin Pract. 2009;84(2):e33-7.
  5. Ras RT, Geleijnse JM, Trautwein EA. LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies. Br J Nutr. 2014;112(2):214-9.
  6. American Diabetes Association. Standards of Medical Care in Diabetes 2017.
  7. Diabetes UK. Evidence-based Nutrition Guidelines for the prevention and management of diabetes 2011.