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Risk Factors for Cardiovascular Disease (CVD) in Adults with Type 1 Diabetes: Findings from Prospective Real-life T1D Exchange Registry.

  • Shah, Viral N1
  • Bailey, Ryan2
  • Wu, Mengdi2
  • Foster, Nicole C2
  • Pop-Busui, Rodica3
  • Katz, Michelle4
  • Crandall, Jill5
  • Bacha, Fida6
  • Nadeau, Kristen1
  • Libman, Ingrid7
  • Hiers, Paul8
  • Mizokami-Stout, Kara3
  • DiMeglio, Linda A9
  • Sherr, Jennifer10
  • Pratley, Richard11
  • Agarwal, Shivani12
  • Snell-Bergeon, Janet1
  • Cengiz, Eda10
  • Polsky, Sarit6
  • Mehta, Sanjeev N4
  • 1 Barbara Davis Center for Diabetes, Aurora, Colorado.
  • 2 Jaeb Center for Health Research, Tampa, Florida.
  • 3 University of Michigan, Ann Arbor, Michigan.
  • 4 Joslin Diabetes Center, Boston, Massachusetts.
  • 5 Albert Einstein College of Medicine, New York, New York.
  • 6 Baylor College of Medicine, Houston, Texas.
  • 7 Childrens Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania.
  • 8 University of Florida, Gainesville, Florida.
  • 9 Indiana University, School of Medicine, Indianapolis, Indiana. , (India)
  • 10 Yale School of Medicine, New Haven, Connecticut.
  • 11 AdventHealth Translational Research Institute for Metabolism and Diabetes, Orlando, Florida.
  • 12 University of Pennsylvania, Philadelphia, Pennsylvania.
Published Article
The Journal of Clinical Endocrinology & Metabolism
The Endocrine Society
Publication Date
May 01, 2020
DOI: 10.1210/clinem/dgaa015
PMID: 31955209


Cardiovascular disease (CVD) is a major cause of mortality in adults with type 1 diabetes. We prospectively evaluated CVD risk factors in a large, contemporary cohort of adults with type 1 diabetes living in the United States. Observational study of CVD and CVD risk factors over a median of 5.3 years. The T1D Exchange clinic network. Adults (age ≥ 18 years) with type 1 diabetes and without known CVD diagnosed before or at enrollment. Associations between CVD risk factors and incident CVD were assessed by multivariable logistic regression. The study included 8,727 participants (53% female, 88% non-Hispanic white, median age 33 years [interquartile ratio {IQR} = 21, 48], type 1 diabetes duration 16 years [IQR = 9, 26]). At enrollment, median HbA1c was 7.6% (66 mmol/mol) (IQR = 6.9 [52], 8.6 [70]), 33% used a statin, and 37% used blood pressure medication. Over a mean follow-up of 4.6 years, 325 (3.7%) participants developed incident CVD. Ischemic heart disease was the most common CVD event. Increasing age, body mass index, HbA1c, presence of hypertension and dyslipidemia, increasing duration of diabetes, and diabetic nephropathy were associated with increased risk for CVD. There were no significant gender differences in CVD risk. HbA1c, hypertension, dyslipidemia and diabetic nephropathy are important risk factors for CVD in adults with type 1 diabetes. A longer follow-up is likely required to assess the impact of other traditional CVD risk factors on incident CVD in the current era. © Endocrine Society 2020. All rights reserved. For permissions, please e-mail: [email protected]

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