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    Home > Active Ingredient News > Endocrine System > How does the cardiovascular risk of patients with type 1 diabetes change in their lifetime?

    How does the cardiovascular risk of patients with type 1 diabetes change in their lifetime?

    • Last Update: 2021-10-11
    • Source: Internet
    • Author: User
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    ▎Cardiovascular disease, edited by WuXi AppTec's content team, is one of the important complications of type 1 diabetes patients and one of the main factors for their premature death
    .

    However, with the continuous improvement of diabetes and cardiovascular disease diagnosis and treatment methods, after diagnosis of type 1 diabetes, especially in childhood-onset type 1 diabetes patients, there is not much updated evidence of the long-term trend of the cumulative incidence of cardiovascular disease
    .

    Recently, "The Lancet-Diabetes and Endocrinology" published a 50-year study from Finland at the national level, revealing the changes in cardiovascular disease risk in patients with type 1 diabetes at different ages, and the heart of patients diagnosed with onset in different years.
    Continuous improvement of blood vessel health
    .

    According to the paper, Finland is one of the countries with the highest incidence of type 1 diabetes in the world, and the data from this study are therefore particularly convincing
    .

    Overall, research data shows that in the past 50 years, the burden of microvascular complications and cardiovascular disease in patients with type 1 diabetes has decreased
    .

    Although the long-term trend has improved, the risk of cardiovascular disease is still much higher than that of the general population, especially those under 35 years of age
    .

    Screenshot source: The Lancet Diabetes & Endocrinology This is a retrospective cohort study that included all Finnish patients who were diagnosed with type 1 diabetes between January 1, 1965 and December 31, 1999 and were under 15 years of age at the time of diagnosis.
    11766 patients were monitored for cardiovascular disease until 2016, and follow-up for deaths from cardiovascular disease until 2017
    .

    The median follow-up time was up to 29.
    6 years
    .

    During the follow-up period, a total of 1761 people had a single type or multiple types of cardiovascular disease events, and a total of 2686 cardiovascular events were reported, including: 864 (32.
    2%) coronary artery disease events, of which 663 were acute myocardial infarction; 497 cases (18.
    5%) had stroke; 854 cases (31.
    8%) had peripheral arterial disease, of which 498 cases had lower limb amputation; 471 cases (17.
    5%) had heart failure
    .

    Statistics have found that in Finland, the risk of cardiovascular disease in childhood type 1 diabetes has decreased over time
    .

    Type 1 diabetes is diagnosed every night for one year, and the risk of cardiovascular disease decreases linearly by 3.
    8% (HR0.
    96, p<0.
    0001)
    .

    This trend is similar in different cardiovascular diseases
    .

    For patients diagnosed during 1965-1969, the cumulative incidence of any cardiovascular disease in the following 50 years was 45.
    8%
    .

    Male patients have a higher overall risk
    .

    From a 25-year cumulative incidence rate: 7.
    5% of patients diagnosed in 1965-1969, 5.
    2% of patients diagnosed in 1970-1974, 6.
    0% of patients diagnosed in 1975-1979, 3.
    8% of patients diagnosed in 1980-1984, 1985 -3.
    3% of patients diagnosed in 1989, 3.
    1% of patients diagnosed in 1990-1995, and 1.
    8% of patients diagnosed in 1995-1999
    .

    Image source: 123RF However, compared with the general population, the risk of cardiovascular disease in patients with type 1 diabetes is still quite high
    .

    Overall, in all patients with type 1 diabetes covered by the study, the risk of coronary artery disease is 10.
    9 times that of the general population, and the risk of stroke is 5.
    9 times that of the general population
    .

    The risk of coronary artery disease in women with type 1 diabetes (25.
    5 times) is significantly higher than that of men (8.
    0 times)
    .

    However, during the life of the patient, as the age increases, the risk gap with the general population continues to shrink: in patients aged 25-34, the risk of coronary artery disease is 25.
    1 times that of the general population, and the risk of stroke is 5.
    4 times; at 55-64 Among age-old patients, the risk of coronary artery disease is 6.
    7 times that of the general population, and the risk of stroke is 3.
    5 times
    .

    At the same time, as time goes by, patients diagnosed in different years, at the same age, the additional risk of cardiovascular disease compared to the general population is gradually decreasing
    .

    For example, at the age of 25-34, the risk of coronary artery disease in patients diagnosed in the 1970s and 1974 was 36.
    3 times that of the general population, while the risk of coronary artery disease in patients diagnosed in the 1990s was 8.
    9 times
    .

    For stroke, the 35-44 age group has the most significant improvement in risk.
    Patients diagnosed in 1965-1969 have a stroke risk 10.
    3 times that of the general population, and those diagnosed in 1985-1989 have a stroke risk of 3.
    9 times
    .

    It is worth noting that even in patients diagnosed in the 1990s, the risk of stroke is still 2.
    9 times that of the general population
    .

    ▲Compared with the general population, the risk of coronary artery disease (A) and stroke (B) in patients diagnosed in different ages and at different ages (picture source: reference [1]) In addition, a total of 1467 cases have been reported as of the end of 2017 Of the deaths, 538 cases (36.
    7%) were due to cardiovascular causes
    .

    With the passage of time, the death rate of cardiovascular disease in patients with type 1 diabetes has also been declining
    .

    Among patients diagnosed in 1965-1969, patients diagnosed in 1970-1974, patients diagnosed in 1975-1979, and patients diagnosed in 1980-1984, the 35-year cumulative mortality rate after diagnosis was 7.
    5%, 5.
    1%, 3.
    6%, and 2.
    0%, respectively
    .

    Based on these findings, the paper summarized and emphasized that it is necessary for us to understand the atherosclerosis mechanism of type 1 diabetic patients from the beginning of diagnosis, in order to promote the early and effective prevention of cardiovascular disease in these patients
    .

    In a review article published in the same period of "The Lancet-Diabetes and Endocrinology", Professor Trevor J.
    Orchard of the University of Pittsburgh pointed out, "The management of type 1 diabetes faces many challenges, requiring frequent blood glucose monitoring and insulin adjustment.
    Dosage avoids acute complications to prevent long-term complications
    .
    In
    terms of total burden and mortality, the most important of these long-term complications is cardiovascular disease
    .

    ” However, “Cardiovascular disease prevention strategies for patients with type 1 diabetes are not It should be inferred from the type 2 diabetes population that the two diseases are very different
    .
    It
    should not be specified because of insufficient evidence for type 1 diabetes (prevention strategies)
    .

    "This study has brought important evidence to show that patients with type 1 diabetes are very different .
    The risk of cardiovascular disease is still higher than that of ordinary people, and we still have a lot of prevention work to do
    .

    Related reading 32-year follow-up of type 1 diabetes: severe cognitive decline, these 3 points are equivalent to 9.
    4 years old! The Lancet Sub-Journal: Preserving β-cell function, Imatinib has the potential to change the progression of type 1 diabetes Study NEJM: Keep insulin secretion, and immunotherapy will move towards "cure" type 1 diabetes! Early sugar control is too important to determine the risk of death and myocardial infarction in the next 20 years! The Type 2 Diabetes Milestone Study adds additional evidence references [1] Valma Harjutsalo, Drazenka Pongrac Barlovic, Per-Henrik Groop.
    (2021).
    Long-term population-based trends in the incidence of cardiovascular disease in individuals with type 1 diabetes from Finland : a retrospective, nationwide, cohort study.
    The Lancet Diabetes & Endocrinology, DOI: https://doi.
    org/10.
    1016/S2213-8587(21)00172-8[2] Trevor J.
    Orchard.
    (2021).
    Cardiovascular disease in type 1 diabetes: a continuing challenge.
    The Lancet Diabetes & Endocrinology, DOI: https://doi.
    org/10.
    1016/S2213-8587(21)00190-X[3] Cardiovascular Disease a Continuing Challenge in Type 1 Diabetes.
    Retrieved August 24, 2021, from https://
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    .

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    .

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    .

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