Cardiovascular disease in type 1 diabetes mellitus

Abstract

The association between type 1 diabetes and coronary heart disease has become very clear since the late 1970. It has been demonstrated that there is an important increased risk in morbidity and mortality caused by coronary artery disease in young adults with type 1 diabetes compared with the non diabetic population. The underlying pathogeneses is still poorly understood. While the role of glycemic control in the development of microvascular disease complication is well established its role in CVD in patients with DM1 remains unclear with epidemiologic studies reporting conflicting data. Recent findings from the DCCT/EDIC showed that prior intensive diabetes treatment during the DCCT was associated with less atherosclerosis, largely because of reduced level of HbA1c during the DCCT. The improvement of glycemic control itself appeared to be particularly effective in younger patients with shorter duration of the disease. Other analyses suggested the glycemia may have a stronger effect on CAD in patients without than in those with albuminúria. Other major determinants of coronary artery disease are the components of metabolic syndrome and the surrogate measure of insulin resistence: eGDR. It is proposed that patients with DM1 should have aggressive medical therapy, risk factor modification and careful monitoring not only of his blood sugar but also of the other processes involved in the atherosclerotic process, mostly the ones with family history of type 2 diabetes.

Dyslipidemia in young patients with type 1 diabetes mellitus

“…Better GC is associated with improved survival in patients with T1D, leading to progressive changes in the causes of mortality, particularly cardiovascular disease; therefore, it is important to identify the risk factors for cardiovascular disease in this population (25)(26)(27)(28)(29)(30)(31).…”

Serum levels of endothelial monocyte activating polypeptide-II in type 1 diabetes patients with microangyopathy and arterial hypertention.

“…Установлено, что атеросклеротические изменения в сосудистой стенке появляются задолго до их клини-ческих признаков [6]. Многочисленные исследования указывают на то, что атеросклеротический процесс начинается уже в подростковом возрасте, а его про-грессирование определяется теми же факторами, что и у взрослых [7].…”

Early aggressive macrovascular disease and type 1 diabetes mellitus without chronic complications: a case report

“…Nephropathy is a more significant risk predictor, which has already been recognized, confirmed and has long been associated with an overall increased mortality risk, particularly due to cardiovascular disease [13]. Besides reflecting the increase in insulin resistance, possibly the culprit in the pathogenesis of CAD in T1D, microalbuminuria is also a marker of impairment of renal function in its early stages as stated by Steno Investigators [14].…”