Diabetes and risk factors for coronary artery disease

Various epidemiological studies had consistently reported high prevalence rates of diabetes among migrant Indians compared to the native population. The most common and life-threatening disorder that besets type 2 diabetic subjects is coronary artery disease (CAD). The risk for CAD among diabetic subjects is greater by a factor of 2 to 4 compared to non-diabetic subjects. It is well known that Asian Indians have greater risk of developing CAD compared to other ethnic populations. The results of the Chennai Urban Population Study (CUPS) revealed that overall 11% of the total population studied had CAD. This is 10 times higher compared to that reported 40 years ago. 21.4% of the diabetic subjects and 14.9% of the subjects with impaired glucose tolerance had CAD compared to 9.1% among subjects with normal glucose tolerance. The reason for the enhanced susceptibility for CAD among diabetic subjects is still not clear. However, cardiovascular risk factors have been shown to be more pronounced among diabetic subjects. Further, the diabetes-specific factors like hyperglycaemia, advanced glycation products, altered lipoproteins and hypercoagulation tends to partly explain the high risk for CAD. The review focuses on the traditional and newer cardiovascular risk factors and discusses their contributory role for CAD and their association with diabetes