Millions of diabetes sufferers around the world can avoid unnecessary medication thanks to research led by a University of Auckland epidemiologist and published in the leading medical journal The Lancet.
Research by Professor Rod Jackson’s team suggests that international treatment guidelines for diabetes overestimate patients’ risk for cardiovascular problems such as heart disease and stroke.
That means some patients are receiving expensive drug treatments that they don’t really need, according to the study, which is currently being called “Cardiovascular Risk Prediction for Type 2 Diabetes Before and After Widespread Screening: A Derivation and Validation Study” has been published.
New Zealand’s global leadership in screening for cardiovascular risk, which includes screening almost every middle-aged adult for diabetes, means this country is at the forefront of research into diabetes, a chronic health condition that is increasing along with obesity and Hundreds of people affects millions of people.
Professor Jackson led a team that included academics from the University of Auckland’s Faculty of Medicine and Health Sciences, as well as colleagues in the field from the Waitemata, Auckland and Manukau Counties, University of Otago and Department of Health departments.
While international treatment guidelines consider most people with diabetes to be at high risk for cardiovascular problems, the team showed how increased early detection of diabetes – the coverage of a larger proportion of the diabetes population – changes the risk profile.
In New Zealand, a world’s first national program resulted in approximately 90% of eligible adults being screened for diabetes by 2016, up from 50% in 2012. The broader screening identified many asymptomatic patients with emerging diabetes.
“We hypothesized that equations for predicting cardiovascular risk that were derived prior to widespread screening would now significantly overestimate risk,” the researchers write in the article.
That was the case in a study with 46,652 patients.
“These results have significant international implications as increased diabetes screening is inevitable due to increasing obesity, simpler screening tests, and the introduction of new generation anti-glucose drugs that prevent cardiovascular events,” said the researchers.
In Aotearoa New Zealand, research is already making a difference. “For the first time, GPs here in New Zealand can use risk prediction equations developed and derived from New Zealand patients,” says Professor Jackson. “ Most GPs are using them now. These are currently the most accurate equations in the world for predicting heart attack and stroke risk in people with diabetes. ”
The research was funded by the Health Research Council of New Zealand, the Heart Foundation of New Zealand and the Healthier Lives National Science Challenge.
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