The International Diabetes Federation (IDF) estimates that worldwide, 415 million people have diabetes, 91% of whom have type 2 diabetes mellitus (T2DM). People with diabetes comprise 8.8% of the world’s population, and IDF predicts that the number of cases of diabetes will rise to 642 million by 2040. The prevalence of T2DM has been steadily increasing over time. Using data from the Framingham Heart Study, Abraham et al. noted that the overall annualized incidence rates of the disease per 1000 persons increased from 3.0 in the 1970s to 5.5 in the first decade of the 2000s. That change represented an increase in the incidence of T2DM of 83.3% and was higher in males than females by a factor of 1.61.
Cardiovascular disease (CVD) is a major cause of death and disability among people with diabetes. Adults with diabetes historically have a higher prevalence rate of CVD than adults without diabetes, and the risk of CVD increases continuously with rising fasting plasma glucose levels, even before reaching levels sufficient for a diabetes diagnosis.
T2DM reduces life expectancy by as much as 10 years, and the main cause of death for patients with T2DM is CVD. Furthermore, people with T2DM are disproportionately affected by CVD compared with non-diabetic subjects. Haffner et al. reported death rates due to cardiovascular causes over a 7-year period in patients with and without T2DM. In persons with T2DM, the death rates were 15.4% for those with no prior myocardial infarction (MI) and 42.0% in patients having a history of MI. In contrast, patients who did not have T2DM, the death rates due to cardiovascular causes were 2.1 and 15.9%, respectively.