Since diabetes and cardiovascular disease share similar pathophysiological mechanisms, promoting good heart health may reduce the risk of further diabetes complications such as diabetic retinopathy. The LE8 patient handouts can be downloaded at www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8. Click images to enlarge.

Risk factor modification is an important component of type 2 diabetes management to reduce chances of mortality and comorbid vascular complications such as cardiovascular disease and diabetic retinopathy. A campaign called “Life’s Essential 8” (LE8) is the American Heart Association’s newly updated measure for cardiovascular health, expanding upon 2010’s LE7. It includes four health behaviors and four health factors, including diet, physical activity, tobacco/nicotine exposure, sleep health, BMI, non-high-density lipoprotein cholesterol, blood glucose and blood pressure. Each metric is scored from 0 to 100 points.

In a study recently published in Primary Care Diabetes, researchers described LE8’s performance in relation to vascular complications in patients with type 2 diabetes. They found that LE8 was strongly and inversely associated with risk for diabetic retinopathy, all-cause mortality and cardiovascular-specific mortality.

Of the 3,192 National Health and Nutrition Examination Survey participants included in the study’s final analysis, 648 had DR at baseline. During the follow-up period, 645 overall deaths were recorded, demonstrating a 26.5% incidence per 1,000 person-years; 216 of these deaths were from cardiovascular causes (9.0% incidence).

Diabetic retinopathy had an adjusted odds ratio per 100-point increase of LE8 score of 0.8. The researchers found that participants with high levels of LE8 adherence were associated with a 47% risk reduction. All-cause mortality and cardiovascular mortality had adjusted hazard ratios per 100-point increase of LE8 of 0.71 and 0.68, respectively.

The researchers observed similar patterns of inverse associations in participants with moderate and high levels of LE8 for all-cause and cardiovascular mortality. Associations between LE8 and mortality were stronger in participants under the age of 60. LE8 was also linearly correlated with all-cause mortality.

“These findings suggested that improving the cardiovascular health among people with type 2 diabetes mellitus is beneficial for improving prognosis, and LE8 might be a feasible and effective approach in the tertiary prevention of type 2 diabetes mellitus,” the researchers concluded in their paper.