Patients with obvious risk factors can be treated, but for the patients who don’t have
obvious risk factors, their first indictor of heart disease is often in the form of a heart
attack or stroke – or even death.
Current methods to measure plaque buildup are invasive and costly, and are not used
to screen patients who don’t display signs of heart disease. However, the coronary
computed tomography angiography (CCTA) offers a new, and less invasive way to
screen these patients for heart disease.
“It may be that in diabetic patients without any symptoms of heart disease, their BMI
could be used to determine if they need a CT scan to screen for plaque buildup,” said
Muhlestein. “We could then develop a treatment plan for at-risk patients.
Findings from the study may also change the way diabetic patients are treated. Current
diabetic management strategies include three options:
- Insulin-sensitizing medication to help the body’s tissues become more sensitive
to insulin and decrease glucose production
- Insulin-stimulating therapy to increase the pancreas’ production of insulin
- Insulin injections
When patients are treated with insulin therapy and injections, they commonly
experience weight gain. “When you provide more insulin, it’s associated in almost every
study with increased weight gain,” said Dr. Muhlestein.
While weight gain does not necessarily predict heart disease in non-diabetics, the
findings of this study shows that weight gain in diabetics can indicate the buildup of
plaque. This is significant because the degree of weight gain can be reduced by using
other types of diabetic treatments, such as insulin sensitizing medication.
“Based on the findings of this study, choosing insulin sensitizing therapy, as the primary
management strategy in diabetic patients may be beneficial by reducing the tendency
towards elevated BMI’s, said Dr. Muhlestein.
Not only will the results of this study help researchers better understand which
treatments will reduce weight gain, but they will also help researchers predict who will
get heart disease – which will help physicians offer better long-term diabetic treatments
to their patients.
“Our goal at the Intermountain Medical Center Heart Institute, is to learn how to predict
who will get heart disease, so we can provide the best care possible and improve long-term outcomes – rather than waiting until a person has a heart attack or even dies,” he
Other researchers involved in the study include: Alan C. Kwan, Heidi May, George
Cater, Christopher T. Sibley, Boaz Rosen, Joao A.C. Lima, Donald Lappe, Jeffrey L.
Anderson and David A. Bluemke.
Intermountain Heart Institute at Intermountain Medical Center is the most advanced
heart program in the Intermountain West with highly specialized experts in all areas of
heart care. Intermountain Medical Center is the flagship hospital for the Intermountain
Healthcare system based in Salt Lake City.