title: Myocardial infarction and stroke in early years after diagnosis of type 2 diabetes: risk factors and relation to self-monitoring of blood glucose.
abstract: BACKGROUND
  The natural course of macrovascular events in patients with type 2 diabetes was analyzed: what are the risk factors, and what is the relationship to the use of self-monitoring of blood glucose (SMBG)?
  
  
  METHODS
  Data were retrieved from ROSSO-a German retrospective observational study-which followed 3,268 patients from diagnosis of type 2 diabetes for 6.5 +/- 1.6 years. We compared patients with or without a nonfatal macrovascular event (myocardial infarction or stroke) and patients using or not using SMBG.
  
  
  RESULTS
  At baseline, worse glycemic control and higher body mass index were not risk factors for macrovascular events. Moreover, there was no association with classic risk factors like blood pressure or total cholesterol. Overall, there was a higher incidence of stroke than of myocardial infarction (0.78% vs. 0.51%). Myocardial infarction was positively associated with male sex, and stroke with age (P < 0.001 for each). Patients using SMBG compared to patients not using SMBG had fewer myocardial infarctions (2.0% vs. 4.0%, P = 0.002) and strokes (3.6% vs. 5.7%, P = 0.005), experienced a stroke later after diagnosis of type 2 diabetes (5.1 +/- 1.9 vs. 3.8 +/- 2.1 years, P < 0.001), and had a higher mean hemoglobin A1c in the years before a myocardial infarction (7.8 +/- 1.8% vs. 6.8 +/- 1.1%, P = 0.003) or a stroke (8.0 +/- 1.8% vs. 7.1 +/- 1.2%, P = 0.003). However, classic cardiovascular risk factors did not differ between patients using or not using SMBG.
  
  
  CONCLUSIONS
  In patients with type 2 diabetes SMBG was associated with a lower event rate of myocardial infarction (-50%) and stroke (-37%), although at baseline the classic risk factors for macrovascular events were not different in both groups.
authors.affiliation: German Diabetes Center, Institute for Clinical Diabetes Research , Düsseldorf, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Martin
authors.forename: Hubert
authors.initials: H
authors.lastname: Kolb
authors.forename: Berthold
authors.initials: B
authors.lastname: Schneider
authors.forename: Lutz
authors.initials: L
authors.lastname: Heinemann
authors.forename: Christian
authors.initials: C
authors.lastname: Weber
authors.forename: Serge
authors.initials: S
authors.lastname: Kocher
authors.forename: Jacques K T
authors.initials: JK
authors.lastname: Tshiananga
authors.forename: Werner A
authors.initials: WA
authors.lastname: Scherbaum
authors.forename: Volker
authors.initials: V
authors.lastname: Lodwig