Prediabetes also damages the heart

Prediabetes—elevation of blood glucose still within the 'normal' range—was recently reported to increase cancer risk; now a study just published in the journal Circulation demonstrates that prediabetes causes unfelt damage to the heart that substantially raises the risk of future coronary artery disease and heart failure regardless of cholesterol levels. The authors...

"...measured cardiac troponin T with a highly sensitive assay (hs-cTnT) at two time points, 6 years apart, among 9,331 participants...with no diabetes, prediabetes, or diabetes but without cardiovascular disease including silent MI by ECG. First, we examined incidence of elevated hs-cTnT (≥14 ng/L) at 6 years of follow-up. Second, we examined clinical outcomes during the subsequent ~14 years of follow-up among persons with and without incident elevated hs-cTnT. Cumulative probabilities of elevated hs-cTnT at 6 years among persons with no diabetes, prediabetes, and diabetes were 3.7%, 6.4%, and 10.8%, respectively. Compared to normoglycemic persons, the adjusted relative risks for incident elevated hs-cTnT were 1.38 for prediabetes and 2.46 for diabetes. Persons with diabetes and incident elevations in hs-cTnT were at a substantially higher risk of heart failure (HR 6.37), death (HR 4.36) and coronary heart disease (HR 3.84) compared to persons without diabetes and no incident elevation in hs-cTnT. "

That's a 600% increase in risk of heart failure, 400% increase in death and 380% increase in coronary artery disease. Lead author Elizabeth Selvin, PhD of the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland was quoted in DG News:

"It puts what we know about heart damage in diabetes on its head...It looks like diabetes may be slowly killing heart muscle in ways we had not thought of before.”

Regardless of cholesterol and without symptoms

Because the risk of cardiovascular disease associated with prediabetes and diabetes may have nothing to do with cholesterol:

“Statin treatment may not be sufficient to prevent damage to the heart in people with diabetes.”

It's important for clinicians and patients to keep mind that this kind of damages goes on 'under the hood' without apparent symptoms:

“Even though there may be no symptoms yet, our research suggests there is microvascular damage being done to the heart which is leading to heart failure and even death."

The authors of the study state in conclusion:

"Prediabetes and diabetes were independently associated with development of subclinical myocardial damage, as assessed by hs-cTnT, and those persons with evidence of subclinical damage were at highest risk for clinical events. These results support a possible deleterious effect of hyperglycemia on the myocardium, possibly reflecting a microvascular etiology. "