Asia-wide study on reducing chances of diabetes patients developing heart disease under way

SINGAPORE – Researchers are working on an Asia-wide study on preventive treatment for diabetic individuals identified to have a high risk of developing heart disease.

The Asian Diabetes Outcome Prevention Trial (Adopt) study will see researchers from the National Heart Centre Singapore (NHCS) work with their counterparts from Malaysia, China, Taiwan, India and the United Arab Emirates, said NHCS on Friday (Aug 28).

The Adopt team aims to recruit 2,400 volunteers for its study, with follow-up over a duration of four years.

Diabetic individuals with a high risk of heart disease will be identified using blood biomarker-based screening for intensive preventive treatment.

Associate Professor David Sim, NHCS’s director of heart failure programme, said the treatment will involve prescribing drugs typically used to treat heart disease to patients who have been identified as high-risk, but who have no pre-existing cardiovascular diseases.

“If Adopt proves that a simple blood test can identify individuals with diabetes who will benefit from intensive preventive therapy with commonly available medications, results can directly impact clinical practice not only in Singapore, but in other parts of the world,” said Professor Carolyn Lam, a senior consultant at the centre’s Department of Cardiology.

The study follows earlier findings by NHCS researchers – who compared data of Asian and Caucasian patients with heart failure between 2012 and 2016 – that three times as many Asian than Caucasian heart disease patients had diabetes.

Researchers also discovered a unique diabetic heart failure group among lean Asians, challenging the assumption that diabetes is associated with obesity.

This group, characterised by large waist-to-height ratios, had the highest risk of poor hospitalisation outcomes, even when their body mass index was low.

Dr Chanchal Chandramouli, a research fellow at NHCS, said: “The lean diabetic cluster was associated with the worst quality of life and composite outcomes, with 79 per cent greater risk of hospitalisation and mortality at one year, compared with other clusters.”

Four other clusters among patients in Asia that had diabetes and heart failure were the elderly, the young, those who are obese and have hypertension, and those with narrowing arteries or reduced blood flow to the heart.

Said Prof Lam: “Realising the dismal prognosis of lean diabetic patients with heart failure and the lack of proven therapies to improve their prognosis, our team firmly believes that prevention of future cardiac disease among high-risk diabetic asymptomatic individuals is extremely critical.”

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