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Stress Tests Unnecessary for Many Diabetics
By Daniel H. Rasolt
Posted: Sunday, April 19, 2009
(Defeat Diabetes® News) -- While diabetes is a major risk factor for heart disease, tests which determine immediate heart status, namely stress tests, are expensive and often lead to more invasive procedures. A recent study has concluded that unless in a markedly high risk group (diabetics with either family history of heart disease, or with angina), these tests are not worth the cost and discomfort.
The current study aimed to see if standard, regular stress test screenings of diabetics, were beneficial in identifying those most at risk for a cardiovascular event (heart attack or stroke), which is the most common form of death in diabetics. Stress tests are conducted to determine the limitations on blood flow to the heart, in order to see how much stress the heart can handle. Too much or too little stress can lead to abnormal heart beats and angina, which occurs due to insufficient blood flow to the heart. Exercise, dobutamine, nuclear, and echocardiogram stress tests, are among the most common, and have been estimated by the current researchers to cost approximately $1,000 per test. It's also noted that individuals who receive stress tests are much more likely to be subjected to other, more invasive heart tests and procedures, such as cardiac catheterization and stents, which often ultimately prove to be unnecessary.
1,123 diabetic patients were analyzed in the study, with some receiving regular heart screenings, and others not. The researchers concluded that only a small number of individuals were identified as being at high risk through the stress tests, and that the overall preventative effect was insignificant. "Routine screening would have tremendous economic implications and our findings did not indicate that routine stress testing had additional benefit in this population," concludes lead researcher, Professor Lawrence Young. These potential economic implications are global, as their are rising populations of diabetics in poor countries, who struggle mightily to pay for procedures like stress tests.
It's important to reiterate that diabetes is a huge risk factor for heart disease, and that those known to be at high risk should indeed be monitored properly through appropriate tests, but this study is suggesting that the cost-benefit of these tests for average diabetic patients is unsubstantial. Professor Young states that "patients with type 2 diabetes with no symptoms who are feeling well can generally be managed effectively with preventive therapies such as lipid-lowering drugs, blood pressure medication, aspirin and diabetes treatment," but goes on to caution that "on the other hand, stress testing has an important role in evaluating patients with type 2 diabetes who have symptoms suggesting heart disease, since these individuals are at very high risk."
Source: Defeat Diabetes Foundation: Young, Lawrence. Peart, Karen. Yale University news release. April 2009.
Daniel H. Rasolt writes for Defeat Diabetes® News. Read more of his original content articles.
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