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

Abstract

The T1D Exchange (T1DX) Clinic Registry assessed CVD risk factors in a large, contemporary cohort of adults with T1D living in the U.S. To understand the incidence and CVD risk factors, we evaluated the association of CVD risk factors and 5-year risk of CVD in adults ≥18 years of age, without CVD at enrollment in the T1DX. CVD was defined as a composite outcome of clinic reported fatal or non-fatal events of ischemic heart disease and heart failure. Associations between diabetic specific and traditional CVD risk factors and incident CVD were examined by logistic regression adjusting for potential confounders. The study included 4,463 participants (55% female, 91% non-Hispanic white, mean age 41 years, T1D duration 21 years). At enrollment, mean HbA1c was 7.7%, 43% used statin, and 45% used blood pressure medication. Incident CVD was reported by 419 (9.4%) participants during the 5-year follow-up. Age, diabetes duration, elevated BMI, triglycerides (TG), and diabetic nephropathy were associated with greater odds of CVD [Table]. Sex, mean HbA1c, HbA1c variability, pulse pressure, and hypertension were not associated with CVD. Markers of insulin resistance (BMI and TG) and diabetic nephropathy are important risk factors for CVD. Longer follow-up is required to assess the impact of other CVD risk factors on CVD in adults with T1D. Disclosure S.N. Mehta: None. M. Wu: None. N.C. Foster: None. R. Pop-Busui: Research Support; Self; AstraZeneca. M. Katz: None. J.P. Crandall: None. F. Bacha: Research Support; Self; AstraZeneca, JAEB Center For Health Research, National Institutes of Health, Pediatric Diabetes Consortium. K.J. Nadeau: None. I. Libman: Consultant; Self; Novo Nordisk A/S. P. Hiers: None. K.R. Mizokami-Stout: None. L. DiMeglio: Advisory Panel; Self; Eli Lilly and Company. Research Support; Self; Dexcom, Inc., Medtronic, Sanofi, Caladrius Biosciences, Inc., Janssen Research & Development, Xeris Pharmaceuticals, Inc., Sanofi. J. Sherr: Consultant; Self; Medtronic MiniMed, Inc.. Advisory Panel; Self; Insulet Corporation, Eli Lilly and Company, Bigfoot Biomedical. R.E. Pratley: Other Relationship; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eisai Inc., GlaxoSmithKline plc., Janssen Pharmaceuticals, Inc., Lexicon Pharmaceuticals, Inc., Ligand Pharmaceuticals, Inc., Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk Inc., Pfizer Inc., Sanofi-Aventis, Takeda Development Center Americas, Inc.. S. Agarwal: None. J.K. Snell-Bergeon: Stock/Shareholder; Self; Abbott. Research Support; Self; Roche Diagnostics Corporation. E. Cengiz: Advisory Panel; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc.. Advisory Panel; Self; MannKind Corporation, ADOCIA, Arecor. S. Polsky: Research Support; Self; Dexcom, Inc.. Other Relationship; Self; T1D Exchange. Research Support; Self; National Institute of Diabetes and Digestive and Kidney Diseases. V.N. Shah: None.