Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor
To The Editor: The NCEP-ATP III Executive Summary1 states that "diabetes counts as a CHD risk equivalent
because it confers a high risk of new CHD within 10 years."
This conclusion may be based in large part upon the study by Haffner
et al2 of myocardial infarction risk in
subjects with type 2 diabetes mellitus without previous myocardial infarction.
The cardiovascular risk of diabetes is likely related to the degree of control,
however. It may only be appropriate to consider poorly
controlled diabetes to be a CHD risk equivalent, as the subjects in the report
by Haffner et al had a fasting plasma glucose of 210 mg/dL (11.67 mmol/L).
Ring BL. Guidelines for Diagnosis and Treatment of High Cholesterol. JAMA. 2001;286(19):2400-2402. doi:10.1001/jama.286.19.2398