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To the Editor: Dr Gu and colleagues¹ found that patients with diabetes experienced fewer declines in heart disease mortality in 1982-1984 vs 1971-1975, compared with nondiabetic individuals during the same periods, and suggest that the incidence of coronary heart disease may have decreased less in patients with diabetes. However, since weight gain is a known complication of insulin and oral hypoglycemic agents, it is possible that weight gain and associated hyperlipidemia secondary to medical management is preventing individuals with type 2 diabetes from fully participating in the declining mortality from coronary heart disease.

John M. Poothullil, MD
Brazosport Memorial Hospital
Lake Jackson, Tex

1. Gu K, Cowie CC, Harris MI. Diabetes and decline in heart disease mortality in US adults. JAMA. 1999;281:1291-1297. FREE FULL TEXT

In Reply: Undoubtedly, many factors influenced the lower decline in mortality from ischemic heart disease among patients with diabetes compared with nondiabetic patients during 1971 to 1993. The well-known mortality decline in the general population has been attributed to reduction in cardiovascular risk factors and better treatment . . . [Full Text of this Article]

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RELATED ARTICLE

Diabetes and Decline in Heart Disease Mortality in US Adults
Ken Gu, Catherine C. Cowie, and Maureen I. Harris
JAMA. 1999;281(14):1291-1297.
ABSTRACT | FULL TEXT