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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2003;23:1715.)
© 2003 American Heart Association, Inc.

Editorials

Is Type 2 Diabetes Mellitus a Vascular Condition?

Frank B. Hu; Meir J. Stampfer

From the Departments of Nutrition and Epidemiology, Harvard School of Public Health, Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Mass.

Correspondence to Dr Frank Hu, Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave, Boston, MA 02115. E-mail fhu@channing.harvard.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Cardiovascular disease (CVD) is the most common complication of type 2 diabetes. However, CVD risk factors are elevated long before the development of diabetes,¹ and the development of CVD can also precede the clinical diagnosis of type 2 diabetes.² The close relationship between diabetes and CVD has led to the "common-soil" hypothesis,³ postulating that type 2 diabetes and CVD share common genetic and environmental antecedents, ie, "they spring from a common soil." The hypothesis implies that atherosclerosis might not be simply a consequence of diabetes but that diabetes and CVD are a single entity sharing an underlying pathophysiology.

See page 1845

Multiple lines of evidence support the common-soil hypothesis. In epidemiologic studies, the same set of diet and lifestyle factors (a diet higher in glycemic load and trans fat and lower in fiber and polyunsaturated fat, smoking, overweight and obesity, lack of regular exercise, and abstinence from alcohol) explains more than 80% of cases of coronary heart disease⁴ and 90% of cases of type 2 diabetes.⁵ Low birth weight, a marker of intrauterine nutritional deficiency, has been associated with increased risk of both diabetes and CVD in later life.⁶ In addition, pharmacological and lifestyle strategies to prevent type 2 diabetes have resulted in significant reductions in the occurrence of the metabolic syndrome and cardiovascular risk factors in subjects with impaired glucose tolerance,⁷ although it remains to be seen whether this will translate into a reduction in clinical CVD events. Furthermore, hypertension and dyslipidemia are significant predictors of type 2 diabetes, . . . [Full Text of this Article]

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