None of these risk differences were affected by more typical risk factors for heart attack, such as inflammation of the arteries.
"The bottom line was that men who had had diabetes longer, in other words early-onset diabetes diagnosed [in this study] before age 60, had more heart attacks and more events," Scott said. "And therefore they truly did look equivalent to patients who had had a prior heart attack and no diabetes. It looks like it really was an equivalent," he added.
"If a male aged 60 walks into my office who just got diagnosed yesterday and didn't have any known heart disease, I might not be as aggressive [in treating him] as we are today," he noted. "That way the patient has less side effects to the medicine and less cost."
But another expert said that clinical implications from the new study remain unclear.
Dr. Chad Teeters, assistant professor of clinical medicine at the University of Rochester Medical Center, said that one problem with the study was that the patients were all older, many had heart risk factors known as "metabolic syndrome," and many were physically inactive, all of which are risk factors for heart disease.
Given this limitation, he said, the new research "doesn't change the game" of how patients are treated.
The study didn't look at men under the age of 60, but the authors did note that people are now getting diagnosed with type 2 diabetes at earlier and earlier ages, perhaps indicating more people who are in need of more aggressive treatment.
And what about the heart risks posed to women by diabetes?
According to Teeters, "Cardiac risk in women doesn't begin to accumulate until later in life due to the protective effects of estrogen, so the effect of duration of diabetes may or may not be similarly associated with cardiac risk in women as it is in men."
Another expert agreed.
All rights reserved