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Debunking the Myth of Diabetes Mellitus as Cardiovascular Disease Equivalent: What Took So Long?


Purpose of Review

Individuals with diabetes mellitus (DM) have historically been reported to have the same risk of having a future myocardial infarction (MI) as an individual with known coronary heart disease (CHD). In other words, DM has been widely accepted as a coronary heart disease (CHD) equivalent. We review the literature that established DM as a CHD risk equivalent and how over time it has become clear that DM carries a spectrum of risk.

Recent Findings

Newer studies suggest that DM is heterogeneous, with certain subgroups such as women, those with longer duration of DM, and increased severity of disease may be more susceptible to downstream complications and cardiovascular events than those in other subgroups. The use of coronary artery calcium scoring for risk stratification in this group has now been shown to have clinical utility.


DM surely does infer increased risk of developing coronary heart disease upon an individual; however, this risk is not as high as historically presumed. Certain subgroups among the DM population may have a higher risk of CHD when identified by burden of subclinical disease; these individuals can be identified early to begin personalized management of their disease.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Corresponding author

Correspondence to Shaista Malik.

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Shaista Malik and Erum Iqbal Bajwa declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Novel and Emerging Risk Factors

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Bajwa, E.I., Malik, S. Debunking the Myth of Diabetes Mellitus as Cardiovascular Disease Equivalent: What Took So Long?. Curr Cardiovasc Risk Rep 12, 20 (2018).

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  • Diabetes mellitus
  • Coronary artery disease
  • Coronary heart disease
  • CHD risk equivalent
  • Coronary calcium