Do traditional cardiovascular risk factors solely explain intima-media thickening in youth with type 1 diabetes?

Heyden, Josine C. van der; Birnie, Erwin; Bovenberg, Sarah A.; Cabezas, Manuel Castro; Meulen, N. van der; Mul, Dick; Veeze, Henk J.; Aanstoot, Henk‐Jan

doi:10.1016/j.jdiacomp.2016.03.030

Cited by 6 publications

(6 citation statements)

References 28 publications

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“…Previous studies have established the presence of accelerated vascular ageing and increased arterial stiffness in youth and young adults with T1D (32,33). Early vascular changes may explain the increased SBPs measured across all age groups in our study.…”

Section: Blood Pressuresupporting

confidence: 64%

Differences in lipid and blood pressure measurements between individuals with type 1 diabetes and the general population

Varkevisser

Mul

Aanstoot

et al. 2023

Preprint

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Background: Cardiovascular disease (CVD) is a precarious complication of type 1 diabetes (T1D). Alongside glycaemic control, lipid and blood pressure (BP) management are essential for the prevention of CVD. However, age-specific differences in lipid and BP between individuals with T1D and the general population are relatively unknown. We therefore compared total-, LDL-cholesterol, systolic BP (SBP) and diastolic BP (DBP) in individuals with T1D and the general population. Methods: Cross-sectional data from individuals with T1D visiting six outpatient clinics in the Netherlands were compared to a background population without diabetes from the Lifelines cohort, a multigenerational cohort from the Northern Netherlands. Descriptive statistics were calculated stratified by age group, sex and medication use. Results: In total 2,178 individuals with T1D and 146,822 without diabetes were included in this study. Total- and LDL-cholesterol were lower and SBP and DBP were higher in individuals with T1D in comparison to the background population. When stratified by age and medication use, total- and LDL-cholesterol were lower and SBP and DBP higher in the T1D population. Males with T1D achieved lower LDL-cholesterol levels both with and without medication in older age groups in comparison to females. Females with T1D had up to 8mmHg higher SBP compared to the background population, this difference was not present in males. Conclusion: Lipid and BP measurements are not comparable between individuals with T1D and the general population and are particularly unfavourable for BP in the T1D group. There are potential sex differences in the management of LDL-cholesterol and BP.

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Section: Blood Pressuresupporting

confidence: 64%

Differences in lipid and blood pressure measurements between individuals with type 1 diabetes and the general population

Varkevisser

Mul

Aanstoot

et al. 2023

Preprint

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“…The studies were conducted in the United States, Turkey, Canada, Germany, Egypt, Austria, Poland, Estonia, Finland, Greece, Australia, Norway, Mexico, Sweden, Serbia, and the Netherlands between 2002 and 2017. Twenty studies included cIMT as outcome, 11,12,14,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] and four included carotid-femoral PWV as outcome. 13,14,36,37 The characteristics of all 23 studies used for the systematic review are summarized in Table 1.…”

Section: Search Results and Characteristics Of The Included Studiesmentioning

confidence: 99%

“…Although the findings from these studies are inconsistent, most of them showed higher cIMT levels in children with type 1 diabetes compared with controls. 11,12 Regarding carotid-femoral PWV there are only a few studies assessing carotid-femoral PWV in young individuals with type 1 diabetes, showing also diverse results. 13,14 The aim of the present study was to systematically review the literature and conduct a meta-analysis comparing markers of subclinical arterial damage, namely cIMT and carotid-femoral PWV, in children and adolescents with type 1 diabetes in comparison to healthy controls.…”

Section: Introductionmentioning

confidence: 99%

Subclinical Arterial Damage in Children and Adolescents with Type 1 Diabetes: A Systematic Review and Meta‐Analysis

et al. 2019

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Background and Objective Type 1 diabetes is an important risk factor for the development of cardiovascular disease. Pulse wave velocity (PWV) and carotid intima‐media thickness (cIMT) measurements are well recognized as independent predictors for future cardiovascular disease. The aim of the present study was to systematically review the literature and conduct a meta‐analysis assessing measures of subclinical arterial damage in children and adolescents with type 1 diabetes in comparison to healthy controls. Methods PubMed and Cochrane Library were searched to identify studies comparing cIMT and carotid‐femoral PWV levels between children with type 1 diabetes and healthy controls. Meta‐analysis was performed to compare the difference of overall mean cIMT and carotid‐femoral PWV levels between the two groups. New Castle Ottawa quality assessment scale for case‐control studies was used to assess study quality. Results Twenty‐three studies were finally included in the meta‐analysis (20 studies for cIMT and 4 studies for carotid‐femoral PWV). Youth with type 1 diabetes had significantly higher cIMT levels than controls (mean difference [d] = 0.03, 95% confidence interval [CI] = 0.02‐0.04), as well as higher carotid‐femoral PWV levels (d = 0.26, 95% CI = 0.18‐0.34). Heterogeneity was present only in the cIMT analysis (I2 > 90%). Conclusions Youth with type 1 diabetes showed signs of subclinical arterial damage, as suggested by higher levels of cIMT and carotid‐femoral PWV compared to healthy controls at childhood and adolescence. Preventive and therapeutic interventions early in course of disease may be further studied to decrease morbidity in this high‐risk young patient group. PROSPERO registration number: 2018 CRD42018094354.

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“…This is particularly troubling as youth and young adults with type 1 diabetes have been demonstrated to have up to a 11-fold increased risk of cardiovascular mortality in comparison to age-matched and sex-matched controls 25. Moreover, atherosclerosis has been observed as early as 6 years after type 1 diabetes onset,26 and in youth and young adults 27 28. Individuals with early onset type 1 diabetes are therefore exposed to risk factors for years before interventions take place 29.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular risk management in people with type 1 diabetes: performance using three guidelines

Varkevisser

Birnie

Vollenbrock

et al. 2022

BMJ Open Diab Res Care

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IntroductionCardiovascular disease (CVD) is the leading cause of mortality in individuals with type 1 diabetes mellitus (T1DM). Cardiovascular risk management is therefore essential in the management of individuals with T1DM. This study describes the performance of lipid and blood pressure management in individuals with T1DM using three guidelines.Research design and methodsIndividuals ≥18 years with T1DM, treated with insulin for ≥1 year, visiting Diabeter or the University Medical Center Groningen between January 1, 2018 and December 31, 2018, were included. Lipid and blood pressure management were examined using the Dutch, American Diabetes Association (ADA) and National Institute for Health and Care Excellence (NICE) guidelines. Concordance of recommended and prescribed lipid-lowering (LLM) or antihypertensive medication (AHM) was assessed per guideline and 10-year age groups. Achievement of treatment targets was assessed for those prescribed medication.ResultsA total of 1855 individuals with T1DM were included. LLM and AHM was prescribed in 19% and 17%, respectively. In individuals recommended LLM, this was prescribed in 22%–46% according to Dutch, ADA or NICE guideline recommendations. For individuals recommended AHM, this was prescribed in 52%–75%. Recommended and actual prescription of LLM and AHM increased over age for all three guidelines. However, discordance between treatment recommendation and medication prescribed was higher in younger, compared with older, age groups. Low-density lipoprotein-cholesterol targets were achieved by 50% (without CVD) and 31% (with CVD) of those prescribed LLM. The blood pressure target was achieved by 46% of those prescribed AHM.ConclusionThis study suggests that there is undertreatment of lipid and blood pressure according to guideline recommendations, particularly in younger age groups. Treatment targets are not met by most individuals prescribed medication, while guidelines recommendations differ considerably. We recommend to investigate the factors influencing undertreatment of lipid and blood pressure management in individuals with T1DM.

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Do traditional cardiovascular risk factors solely explain intima-media thickening in youth with type 1 diabetes?

Cited by 6 publications

References 28 publications

Differences in lipid and blood pressure measurements between individuals with type 1 diabetes and the general population

Differences in lipid and blood pressure measurements between individuals with type 1 diabetes and the general population

Subclinical Arterial Damage in Children and Adolescents with Type 1 Diabetes: A Systematic Review and Meta‐Analysis

Cardiovascular risk management in people with type 1 diabetes: performance using three guidelines

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