Type 2 diabetes is a growing global health problem, representing approximately 90% of all diabetes cases. A recent study reports that type 2 diabetics experience more cold-related cardiorespiratory symptoms than non-diabetics.
Individuals with diabetes have a reduced capacity to maintain a stable body temperature during temperature extremes. This can lead to problems regulating various circulatory, cardiovascular and peripheral neuropathy pathways, causing increased blood pressure, stiffening of the arteries and altered sensory responses. These problems can be exacerbated during cold weather and may aggravate cold-related cardiovascular and respiratory symptoms such as chest pain, coughing and dyspnoea, which are common in the general population during cold weather. Individuals with cardiovascular and respiratory diseases tend to report these symptoms more often during cold weather, but whether individuals with type 2 diabetes or impaired glucose metabolism also report more cold-related symptoms is unknown.
A large, population-based study published in Diabetes Research and Clinical Practice compared the prevalence of cold-related symptoms to glycemic status in 5144 randomly selected individuals who were 45-74 years of age. Questionnaires completed by participants and clinical measurements were obtained from the 2002 and 2007 data sets of the National FINRISK Study, a large survey of the Finnish population designed to analyze risk factors for chronic, non-communicable diseases. The questionnaires gathered information about an individual’s socioeconomic background, cold-related symptoms, medical history and cardiovascular disease (CVD) status. The clinical measurements provided information about body mass index (BMI), blood pressure and arterial hypertension (HTN) status. Glycemic status was determined from fasting blood glucose and oral glucose tolerance tests as well as previous diagnoses. Individuals with Type 1 diabetes were excluded from the study. The remaining participants were divided into five categories: type 2 diabetes, screening-detected type 2 diabetes, impaired glucose tolerance, impaired fasting glucose and normal glucose metabolism.
The authors initially calculated the prevalence of cold-related symptoms for each of the five groups. Patient characteristics were then considered to determine whether variables such as age, gender, BMI or other socioeconomic factors affected the results. The effects of HTN and CVD on the associations between cold-related symptoms and glycemic status were also determined.
Overall, individuals with type 2 diabetes reported more cold-related cardiac and respiratory symptoms, especially dyspnoea, chest pain and arrhythmia. Individuals with screening-detected type 2 diabetes also reported more dyspnoea, coughing and cardiac symptoms. CVD and HTN did not affect the results. A trend between worsening glycemic status and increased reporting of dyspnoea, chest pain and arrhythmia was also observed. The authors speculated that cold-related cardiorespiratory symptoms are more commonly reported as the duration and severity of diabetes progresses.
This study indicates that the various physiological changes associated with diabetes contribute to the elevated cold-related cardiorespiratory symptoms reported by individuals with diabetes and impaired glucose metabolism. Individuals will benefit from information and advice on minimizing the risks presented during cold weather so adverse health events associated with these symptoms are reduced.
Written By: Natasha Tetlow, PhD