According to a study published in January 2020 in Diabetes Care, intensive glucose management in adults with type 1 diabetes avoids an initial or subsequent cardiovascular disease or major adverse cardiovascular disease event. Annual assessment of HbA1c, triglyceride and HDL cholesterol levels in 1,441 adults with type 1 diabetes from the DCCT/EDIC* study (mean age at baseline 27 years; 47% women) has revealed that the strongest modifiable risk factor was HbA1c.
Each 1% rise in mean HbA1c increased risk:
- for an initial CVD event by 38%
- for subsequent CVD events by 28%
- for an initial major adverse cardiovascular event by 54% and
- for subsequent major adverse CV events by 89%.
In addition, it was shown that 10mm Hg increase in systolic blood pressure was associated with higher risks for major adverse CV events and subsequent major adverse CV events. Furthermore, it has been shown that the risk of subsequent serious adverse events was reduced for those who used ACE inhibitors compared to those without medication. Based on available results, intensive glycemic management and the use of antihypertensive drugs are recommended to reduce the risk of first CVD events in type 1 diabetes.
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Bebu I, et al. Diabetes Care. 2020;doi:10.2337/dc19-2292
* DCCT/EDIC - Diabetes Control and Complications Trial and the Epidemiology of Diabetes Interventions and Complications study