Hcy concentrations are a higher risk factor for death in type 2 diabetes patients (non-insulin dependent diabetes) as compared to non-diabetic patients. Ueland, et al., showed that the combined effects of elevated tHcy levels increased the risk of total mortality in 587 diabetes mellitus patients who had been diagnostically confirmed for coronary artery disease. As shown in Figure 10, the investigators concluded that the combination of elevated Hcy and diabetes exponentially increased the risk of mortality in diabetic patients.
Hoogeveen, et al., demonstrated that among type 2 diabetic subjects with tHcy levels >14 μmol/L, the estimated survival time was significantly shorter than type 2 diabetic subjects with tHcy concentrations <14.0 μmol/L (Figure 11).
The elevation of tHcy levels in diabetic patients is believed to be related to the degree of diabetic nephropathy, especially in type 2 diabetes patients who often have metabolic problems and unhealthy lifestyles that may contribute to elevated tHcy concentrations compared with non-diabetic subjects.