scholarly journals Osteopontin Is a Strong Predictor of Incipient Diabetic Nephropathy, Cardiovascular Disease, and All-Cause Mortality in Patients With Type 1 Diabetes

Diabetes Care ◽  
2014 ◽  
Vol 37 (9) ◽  
pp. 2593-2600 ◽  
Author(s):  
Daniel Gordin ◽  
Carol Forsblom ◽  
Nicolae M. Panduru ◽  
Merlin C. Thomas ◽  
Mette Bjerre ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
Strong Predictor ◽  
All Cause Mortality ◽  
Incipient Diabetic Nephropathy

Insulin resistance and risk of vascular events, interventions and mortality in type 1 diabetes

2021 ◽  
Author(s):  
Marga A.g. Helmink ◽  
Marieke de Vries ◽  
Frank L.j. Visseren ◽  
Wendela L. de Ranitz ◽  
Harold W. de Valk ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Insulin Sensitivity ◽  
Lower Risk ◽  
Cardiovascular Events ◽  
Additional Risk Factor ◽  
Vascular Events ◽  
All Cause Mortality

Objective: To identify determinants associated with insulin resistance and to assess the association between insulin resistance and cardiovascular events, vascular interventions and mortality in people with type 1 diabetes at high risk of cardiovascular disease . Design: Prospective cohort study. Methods: 195 people with type 1 diabetes from the Secondary Manifestations of ARTerial disease (SMART) cohort were included. Insulin resistance was quantified by the estimated glucose disposal rate (eGDR) with higher eGDR levels indicating higher insulin sensitivity (i.e. lower eGDR levels indicating higher insulin resistance). Linear regression models were used to evaluate determinants associated with eGDR. The effect of eGDR on cardiovascular events, cardiovascular events or vascular interventions (combined endpoint) and on all-cause mortality was analysed using Cox proportional hazards models adjusted for confounders. Results: In 195 individuals (median follow-up 12.9 years, IQR 6.7-17.0), a total of 25 cardiovascular events, 26 vascular interventions and 27 deaths were observed. High eGDR as a marker for preserved insulin sensitivity was independently associated with a lower risk of cardiovascular events (HR 0.75; 95%CI 0.61-0.91), a lower risk of cardiovascular events and vascular interventions (HR 0.74; 95%CI 0.63-0.87), and a lower risk of all-cause mortality (HR 0.81; 95%CI 0.67-0.98). Conclusions: Insulin resistance as measured by eGDR is an additional risk factor for cardiovascular disease in individuals with type 1 diabetes. Modification of insulin resistance by lifestyle interventions or pharmacological treatment could be a viable therapeutic target to lower the risk of cardiovascular disease.

scholarly journals Risk Factors for Cardiovascular Disease (CVD) in Adults with Type 1 Diabetes: Findings from Prospective Real-life T1D Exchange Registry

2020 ◽  
Vol 105 (5) ◽  
pp. e2032-e2038 ◽  
Author(s):  
Viral N Shah ◽  
Ryan Bailey ◽  
Mengdi Wu ◽  
Nicole C Foster ◽  
Rodica Pop-Busui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
The United States ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Impact

Abstract Context Cardiovascular disease (CVD) is a major cause of mortality in adults with type 1 diabetes. Objective We prospectively evaluated CVD risk factors in a large, contemporary cohort of adults with type 1 diabetes living in the United States. Design Observational study of CVD and CVD risk factors over a median of 5.3 years. Setting The T1D Exchange clinic network. Patients Adults (age ≥ 18 years) with type 1 diabetes and without known CVD diagnosed before or at enrollment. Main Outcome Measure Associations between CVD risk factors and incident CVD were assessed by multivariable logistic regression. Results The study included 8,727 participants (53% female, 88% non-Hispanic white, median age 33 years [interquartile ratio {IQR} = 21, 48], type 1 diabetes duration 16 years [IQR = 9, 26]). At enrollment, median HbA1c was 7.6% (66 mmol/mol) (IQR = 6.9 [52], 8.6 [70]), 33% used a statin, and 37% used blood pressure medication. Over a mean follow-up of 4.6 years, 325 (3.7%) participants developed incident CVD. Ischemic heart disease was the most common CVD event. Increasing age, body mass index, HbA1c, presence of hypertension and dyslipidemia, increasing duration of diabetes, and diabetic nephropathy were associated with increased risk for CVD. There were no significant gender differences in CVD risk. Conclusion HbA1c, hypertension, dyslipidemia and diabetic nephropathy are important risk factors for CVD in adults with type 1 diabetes. A longer follow-up is likely required to assess the impact of other traditional CVD risk factors on incident CVD in the current era.

Pulmonary Dysfunction in Type 1 Diabetes in Relation to Metabolic Long-Term Control and to Incipient Diabetic Nephropathy

Nephron ◽  
1996 ◽  
Vol 74 (2) ◽  
pp. 395-400 ◽  
Author(s):  
Ch. Schnack ◽  
A. Festa ◽  
A.S. Schwarzmaier-D’Assié ◽  
P. Haber ◽  
G. Schernthaner
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
Pulmonary Dysfunction ◽  
Incipient Diabetic Nephropathy

scholarly journals Resistant hypertension and risk of adverse events in individuals with type 1 diabetes: A nationwide prospective study

2020 ◽  
Author(s):  
Raija Lithovius ◽  
Valma Harjutsalo ◽  
Stefan Mutter ◽  
Daniel Gordin ◽  
Carol Forsblom ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
Prospective Study ◽  
Resistant Hypertension ◽  
Antihypertensive Drugs ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Nationally Representative ◽  
Reduced Kidney Function

<b>Objectives</b>. To estimate the risk of diabetic nephropathy (DN) progression, incident coronary heart disease (CHD) and stroke, and all-cause mortality associated with resistant hypertension (RH) in individuals with type 1 diabetes stratified by stages of DN, renal function and sex. <p><b> </b></p> <p><b>Research Design and Methods </b>This prospective study<b> </b>included a nationally representative cohort of individuals with type 1 diabetes from the Finnish Diabetic Nephropathy Study who had purchases of antihypertensive drugs at (±6 months) baseline visit (1995–2008). Individuals (N=1,103) were divided into three groups: (a) RH, (b) uncontrolled BP, but no RH and (c) controlled BP. DN progression, cardiovascular events and deaths were identified from the individuals’ healthcare records and national registries, until 31 December 2015.</p> <p> </p> <p><b>Results</b> At baseline 18.7% of the participants had RH, while 23.4% had controlled BP. After full adjustments for clinical confounders, RH was associated with increased risk of DN progression (HR 1.95 [95% CI 1.37, 2.79], <i>p</i>=0.0002), while no differences were observed in those with no RH<i> </i>(1.05 [0.76, 1.44], <i>p</i>=0.8), compared with those who had controlled BP. The risk of incident CHD, incident stroke and all-cause mortality was higher in individuals with RH compared with those who had controlled BP, but not beyond albuminuria and reduced kidney function. Notably, in those with normo- and microalbuminuria the risk of stroke remained higher in the RH compared to controlled BP group (3.49 [81.20, 10.15], <i>p</i>=0.02).<b> <br></b></p><p><b><br></b></p><p><b>Conclusion </b>Our findings highlight importance to identify and provide diagnostic and therapeutic counseling to these very high risk individuals with RH.</p>

scholarly journals Resistant hypertension and risk of adverse events in individuals with type 1 diabetes: A nationwide prospective study

2020 ◽  
Author(s):  
Raija Lithovius ◽  
Valma Harjutsalo ◽  
Stefan Mutter ◽  
Daniel Gordin ◽  
Carol Forsblom ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
Prospective Study ◽  
Resistant Hypertension ◽  
Antihypertensive Drugs ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Nationally Representative ◽  
Reduced Kidney Function

<b>Objectives</b>. To estimate the risk of diabetic nephropathy (DN) progression, incident coronary heart disease (CHD) and stroke, and all-cause mortality associated with resistant hypertension (RH) in individuals with type 1 diabetes stratified by stages of DN, renal function and sex. <p><b> </b></p> <p><b>Research Design and Methods </b>This prospective study<b> </b>included a nationally representative cohort of individuals with type 1 diabetes from the Finnish Diabetic Nephropathy Study who had purchases of antihypertensive drugs at (±6 months) baseline visit (1995–2008). Individuals (N=1,103) were divided into three groups: (a) RH, (b) uncontrolled BP, but no RH and (c) controlled BP. DN progression, cardiovascular events and deaths were identified from the individuals’ healthcare records and national registries, until 31 December 2015.</p> <p> </p> <p><b>Results</b> At baseline 18.7% of the participants had RH, while 23.4% had controlled BP. After full adjustments for clinical confounders, RH was associated with increased risk of DN progression (HR 1.95 [95% CI 1.37, 2.79], <i>p</i>=0.0002), while no differences were observed in those with no RH<i> </i>(1.05 [0.76, 1.44], <i>p</i>=0.8), compared with those who had controlled BP. The risk of incident CHD, incident stroke and all-cause mortality was higher in individuals with RH compared with those who had controlled BP, but not beyond albuminuria and reduced kidney function. Notably, in those with normo- and microalbuminuria the risk of stroke remained higher in the RH compared to controlled BP group (3.49 [81.20, 10.15], <i>p</i>=0.02).<b> <br></b></p><p><b><br></b></p><p><b>Conclusion </b>Our findings highlight importance to identify and provide diagnostic and therapeutic counseling to these very high risk individuals with RH.</p>

scholarly journals Pulse Pressure Predicts Incident Cardiovascular Disease but Not Diabetic Nephropathy in Patients With Type 1 Diabetes (The FinnDiane Study)

Diabetes Care ◽  
2011 ◽  
Vol 34 (4) ◽  
pp. 886-891 ◽  
Author(s):  
D. Gordin ◽  
J. Waden ◽  
C. Forsblom ◽  
L. Thorn ◽  
M. Rosengard-Barlund ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
Pulse Pressure ◽  
Incident Cardiovascular Disease
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