scholarly journals 30-Year Cardiovascular Disease in Type 1 Diabetes: Risk and Risk Factors Differ by Long-Term Patterns of Glycemic Control

Diabetes Care ◽  
2021 ◽  
pp. dc211381
Author(s):  
Rachel G. Miller ◽  
Trevor J. Orchard ◽  
Tina Costacou
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Diabetes Risk

scholarly journals 30-Year Cardiovascular Disease in Type 1 Diabetes: Risk and Risk Factors Differ by Long-Term Patterns of Glycemic Control

2021 ◽  
Author(s):  
Rachel G. Miller ◽  
Trevor J. Orchard ◽  
Tina Costacou
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Latent Class ◽  
Diabetes Duration ◽  
Cvd Risk ◽  
High Hba1c

<b>Objective:</b> We hypothesized that there is heterogeneity in long-term patterns of glycemic control with respect to cardiovascular disease (CVD) development in type 1 diabetes and that risk factors for CVD differ by glycemic control pattern. Thus, we estimated associations between data-derived latent HbA1c trajectories and 30-year CVD risk in the Pittsburgh Epidemiology of Diabetes Complications (EDC) study of childhood-onset (<17 years old) type 1 diabetes.<b> </b> <p><b>Research Design and Methods: </b>Participants (n=536 with ≥2 HbA1c measurements [median 6] and CVD-free at baseline; mean age 27 and diabetes duration 18 years) were followed from 1986-88 to 2016-18 to ascertain CVD incidence (CVD death, myocardial infarction, stroke, coronary revascularization or blockage ≥50%, ischemic ECG, or angina). Latent HbA1c trajectories and their association with time-to-CVD incidence were simultaneously assessed using Joint Latent Class Mixed Models.</p> <p><b>Results:</b> Two HbA1c trajectories with respect to differential CVD risk were identified: Low (HbA1c ~8% [64 mmol/mol] and improving over follow-up, 76% of cohort) and High (HbA1c ~10% [86 mmol/mol] and stable, 24%). Overall, 30-year CVD incidence was 47.4% (n=253); MACE incidence 31.0% (n=176). High HbA1c was associated with 3-fold increased CVD risk versus Low HbA1c. Both groups had similar age and diabetes duration. Non-HDLc and estimated glomerular filtration rate were associated with CVD risk only in Low HbA1c; albumin excretion rate was associated with CVD risk only in High HbA1c.<b> </b></p> <p><b>Conclusions: </b>These risk factor differences suggest that pathways to CVD may differ by glycemic control, potentially resulting in important implications for prognosis in type 1 diabetes.</p>

scholarly journals Galectin-3 Binding Protein, Depression, and Younger Age Were Independently Associated With Alexithymia in Adult Patients With Type 1 Diabetes

2021 ◽  
Vol 12 ◽  
Author(s):  
Eva O. Melin ◽  
Ralph Svensson ◽  
Jonatan Dereke ◽  
Magnus Hillman
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Abdominal Obesity ◽  
Odds Ratio ◽  
Younger Age ◽  
High Hba1c ◽  
Galectin 3

Aims: Alexithymia has been linked to cardiovascular disease. The aim was to explore whether the immuno-inflammatory variables galectin-3 binding protein (Gal3BP), soluble (s)CD163 and galectin-3 were independently associated with alexithymia, while controlling for known risk factors for cardiovascular disease, such as depression, anxiety, impaired glycemic control, obesity, smoking, and physical inactivity in patients with type 1 diabetes (T1D).Methods: Cross-sectional design. The participants were consecutively recruited from one diabetes out-patient clinic. Alexithymia, depression and anxiety were assessed by self-report instruments. Blood samples, anthropometrics, and blood pressure were collected, supplemented with data from electronic health records. High Gal3BP was defined as ≥3.3 μg/ml, high sCD163 as ≥0.6 μg/ml, high galectin-3 as ≥2.6 ng/ml, impaired glycemic control as HbA1c &gt;70 mmol/mol (&gt;8.6%) and abdominal obesity as waist circumference ≥ 1.02 m for men and ≥ 0.88 m for women.Results: Two hundred and ninety two patients participated (men 56%, aged 18–59 years, alexithymia prevalence 15%). Patients with alexithymia had higher prevalence of depression (34 vs. 6%, p &lt; 0.001), anxiety (61 vs. 30%, p &lt; 0.001), high Gal3BP levels (39 vs. 17%, p = 0.004), high HbA1c levels (46 vs. 24%, p = 0.006), and abdominal obesity (29 vs. 15%, p = 0.045). Depression [adjusted odds ratio (AOR) 6.5, p &lt; 0.001], high Gal3BP levels (AOR 2.4, p = 0.035), and age (AOR 0.96, p = 0.027) were independently associated with alexithymia. Abdominal obesity (AOR 4.0, p &lt; 0.001), high Gal3BP levels (AOR 2.8, p = 0.002), and depression (AOR 2.9, p = 0.014) were associated with high HbA1c. Abdominal obesity and anxiety were associated [Crude odds ratio (COR) 2.4, p = 0.006].Conclusions: T1D patients with alexithymia had higher prevalence of high Gal3BP levels, depression, impaired glycemic control, anxiety, and abdominal obesity, which are known risk factors for cardiovascular disease. Only high Gal3BP levels, depression, and younger age were independently associated with alexithymia in adult patients with T1D.

scholarly journals Glycemic Control, Cardiac Autoimmunity, and Long-Term Risk of Cardiovascular Disease in Type 1 Diabetes Mellitus

Circulation ◽  
2019 ◽  
Vol 139 (6) ◽  
pp. 730-743 ◽  
Author(s):  
Giovane R. Sousa ◽  
David Pober ◽  
Alfonso Galderisi ◽  
HuiJuan Lv ◽  
Liping Yu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Type 1 Diabetes Mellitus

Risk Factors for Cardiovascular Disease (CVD) in Adults with Type 1 Diabetes (T1D)

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 15-LB
Author(s):  
SANJEEV N. MEHTA ◽  
MENGDI WU ◽  
NICOLE C. FOSTER ◽  
RODICA POP-BUSUI ◽  
MICHELLE KATZ ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes

scholarly journals Impact of Fat Intake on Blood Glucose Control and Cardiovascular Risk Factors in Children and Adolescents with Type 1 Diabetes

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2625
Author(s):  
Chiara Garonzi ◽  
Gun Forsander ◽  
Claudio Maffeis
Keyword(s):  
Risk Factors ◽  
Type 1 Diabetes ◽  
Cardiovascular Risk ◽  
Glycemic Control ◽  
Children And Adolescents ◽  
Cardiovascular Risk Factors ◽  
Specific Role ◽  
Fat Intake ◽  
High Fat

Nutrition therapy is a cornerstone of type 1 diabetes (T1D) management. Glycemic control is affected by diet composition, which can contribute to the development of diabetes complications. However, the specific role of macronutrients is still debated, particularly fat intake. This review aims at assessing the relationship between fat intake and glycemic control, cardiovascular risk factors, inflammation, and microbiota, in children and adolescents with T1D. High fat meals are followed by delayed and prolonged hyperglycemia and higher glycated hemoglobin A1c levels have been frequently reported in individuals with T1D consuming high amounts of fat. High fat intake has also been associated with increased cardiovascular risk, which is higher in people with diabetes than in healthy subjects. Finally, high fat meals lead to postprandial pro-inflammatory responses through different mechanisms, including gut microbiota modifications. Different fatty acids were proposed to have a specific role in metabolic regulation, however, further investigation is still necessary. In conclusion, available evidence suggests that a high fat intake should be avoided by children and adolescents with T1D, who should be encouraged to adhere to a healthy and balanced diet, as suggested by ISPAD and ADA recommendations. This nutritional choice might be beneficial for reducing cardiovascular risk and inflammation.

Risk factors for cardiovascular disease and type 1 diabetes mellitus

2000 ◽  
Vol 50 ◽  
pp. 298
Author(s):  
Marino M Noutsou ◽  
Anastasia C Thanopoulou ◽  
Athanasios J Kofinis ◽  
Charalambos D Tountas ◽  
Nikolaos A Papazoglou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus
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