Cardiovascular health in adults with type 1 diabetes

Abstract

Adults with type 1 diabetes (T1D) are at risk for cardiovascular (CV) disease. Managing CV risk is an important prevention strategy. The American Heart Association has defined 7 factors for ideal CV health. The purpose of this 2016 secondary analysis was to assess the prevalence of 6 CV health factors in a sample of adults ≥ 18 (n=7153) in the T1D Exchange Clinic registry. CV health factors include: hemoglobin A1c (HbA1c) < 7 %, BMI < 25kg/m2, blood pressure < 120/80mmHg, total cholesterol < 200mg/dl, non-smoking, and physical activity ≥ 150 minutes/week. HbA1c < 7% was substituted for the AHA health factor of fasting blood glucose. Frequencies of each factor were tabulated for the total sample and for each gender. Logistic regression examined variables associated with achievement of each CV health factor. The mean age was 37.14 ± 17 years. Mean HbA1c was 7.9 ± 1.5 %, and duration was 19.5 ± 13.5 years. The majority (54%) were working full or part-time. Achievement of CV health factors in the whole sample ranged from 27% (HbA1c < 7%) to 94% nonsmoking. Achievement of some factors varied by gender. Common variables associated with several CV health factors included gender, education, employment, and T1D duration. This young sample exhibited low levels of some CV health factors, especially HbA1c and physical activity. Providers need to routinely assess and advise on management of all CV risk factors to prevent this common diabetes complication.

Exercise management in type 1 diabetes: a consensus statement

“…Despite tremendous advances since the discovery of insulin almost 100 years ago, type 1 diabetes (T1D) remains a challenging disease to manage (1,2). A majority of patients living with T1D are not at a healthy body weight (~60% are overweight or obese), suffer from hypertension (~40%) and/or dyslipidaemia (~60%) (3) and are not engaging enough regular physical activity (4). Regular exercise helps patient achieve a number of goals.…”

How prepared are healthcare professionals for delivering physical activity guidance to those with diabetes? A formative evaluation

“…Further, HCPs and patients have cited this lack of knowledge, combined with the fear of hypoglycaemia and a loss of glycaemic control as a primary reason for non-engagement [17]. This fear may, in some way, account for people with diabetes being among the least physically active in society [18] and why a high proportion of patients living with diabetes struggle to maintain a healthy weight [19].…”

Factors associated with high levels of glycated haemoglobin in patients with type 1 diabetes: a multicentre study in Brazil

“… 4 However, most patients with DM1 have HbA1c values ​above the international recommendation of <7.0%. 5 Inadequate glycaemic control (HbA1c levels >7.0%) in patients with DM1 was observed in 77% of the participants of a study in the USA in 2016, 6 in 74% of the study patients in the region of Castilla-La Mancha, Spain in 2012, 7 in 87% of patients surveyed in Venezuela 8 and in 84%–90% of the participants of national multicentre studies conducted in Brazil in 2010 and 2015. 9 10 …”