Diabetics at Risk of Sudden Death
Dec. 3, 1999 (Atlanta) -- Diabetic patients are at risk of sudden cardiac
death, a French research team confirms. And while experts disagree about the
exact causes, they all hope the findings will make doctors increase efforts to
detect and treat heart disease in their diabetic patients.
Death within one hour of the first sign that something is wrong is
considered sudden. In an effort to find out who is at risk of sudden death --
and to find ways to prevent it -- Xavier Jouven, Beverley Balkau, and
colleagues at the French national health institute INSERM studied thousands of
men aged 43-52 years for an average of 17.5 years.
At first, the only major risk factor they could find was having a parent who
experienced a sudden death. But a closer look at the data showed that diabetes
was just as strong a risk factor. Moreover, even early symptoms of diabetes
increased risk of sudden death, with the greatest risk for patients will
full-blown diabetes of all types.
The most frequent cause of death in people with diabetes is heart disease,
usually a heart attack. Oddly, the INSERM study found no link between heart
attacks and sudden death in diabetic patients.
"I cannot explain to you why," Jouven tells WebMD. "I am a
little bit surprised myself."
Bruce Zimmerman, MD, president of the American Diabetes Association, said
that the explanation may simply be that the researchers did not look hard
enough. "There's nothing here that I could see that tells me how they could
have accounted for [heart attack]," Zimmerman tells WebMD in an interview
seeking objective commentary. "To say that they can tell that sudden death
in diabetics is not due to [heart attack] is not established in this."
However, diabetes researcher Diethelm Tschoepe of Heinrich Heine University
in Dusseldorf, Germany, tells WebMD that the INSERM findings suggest that heart
disease in diabetic patients is more complex than commonly appreciated.
Nevertheless, all of these experts agree that people with diabetes should
understand their risk of heart disease. They urge patients to make sure their
doctors are on the lookout for early symptoms, and that they follow
recommendations to reduce their risk.
Balkau even thinks that doctors conduct neurologic evaluations of diabetic
patients. "I think [physicians] need to have much more careful surveillance
of diabetic patients," she tells WebMD. "If sudden death is one of the
outcomes, they need to be followed more carefully. It is not so difficult to do
... a battery of tests for neuropathy."
Zimmerman disagrees the study proves the need for such tests. "We don't
yet know from this data that we should start doing screening of people with
diabetes for neuropathy," he says.
- Diabetic patients have an increased risk of sudden death.
- People with diabetes should have regular heart examinations, and should
carefully follow their doctors' advice about reducing their risk of heart
- Some researchers believe that diabetic patients should have frequent
neurologic examinations, but most doctors think there is not enough evidence to
justify such tests.