Children of diabetics have early artery disease

[unseennude]

Adult children who have two parents with type 2 diabetes, but who are free from the disease themselves, have early signs of atherosclerosis, the results of a small study shows.

Dr. Allison B. Goldfine of Harvard Medical School and the Joslin Diabetes Center in Boston and colleagues found that these individuals had arteries with reduced response to changes in blood flow, known as endothelial dysfunction, an early sign of atherosclerosis, sometimes referred to as "hardening of the arteries."

"Persons with a strong family history of diabetes are at increased risk of atherosclerosis in addition to risk of diabetes," Goldfine commented to Reuters Health. "They may benefit from aggressive cardiovascular risk factor modification, including blood pressure and lipid control, weight management and smoking cessation to reduce their risk of heart attack and stroke."

To investigate whether the offspring of diabetic parents who were free from the disease themselves show early signs of atherosclerosis, Goldfine and her team tested insulin sensitivity and endothelial function in 38 subjects. Half of the subjects had two parents with type 2 diabetes, while the other half had no close relatives with diabetes or coronary artery disease, according to study, published in the Journal of the American College of Cardiology.

The average blood sugar levels were slightly higher in the group with a family history of diabetes, but within normal limits. However, those with a family history of diabetes showed a 38-percent lower arterial response than those with no family history of the disease. Even the most insulin-sensitive members of this group showed impaired arterial function.

This is the first study to demonstrate that modest increases in blood sugar, even in the non-diabetic range, "can contribute to endothelial dysfunction," Goldfine told Reuters Health. "This raises the question of when doctors should recommend interventions to lower glucose levels and what should be the appropriate level of glucose recommended to patients with diabetes."