Changes in glycaemic control and risk of coronary artery disease in type 1 diabetes mellitus: findings from the Pittsburgh Epidemiology of Diabetes Complications Study (EDC)

Prince, Catherine; Becker, Dorothy J.; Costacou, Tina; Miller, Rachel G.; Orchard, Trevor J.

doi:10.1007/s00125-007-0797-7

Cited by 98 publications

(76 citation statements)

References 32 publications

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“…A recent comparative analysis on CVD and coronary artery disease risk in type 1 diabetes, based on findings from the Pittsburgh Epidemiology of Diabetes Complications Study, suggested that glycemia may have a stronger effect on coronary artery disease in patients without albuminuria than in those with albuminuria (24). Our results were different because glycemia had a prominent effect on CVD mortality in type 1 diabetic subjects with proteinuria.…”

Section: -Total and Cvd Mortality During 18 Years Of Follow-up In Typcontrasting

confidence: 86%

Similarity of the Impact of Type 1 and Type 2 Diabetes on Cardiovascular Mortality in Middle-Aged Subjects

et al. 2008

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OBJECTIVE -To compare the risk of cardiovascular disease (CVD) death and the impact of hyperglycemia on the risk of CVD mortality associated with type 1 diabetes to that associated with type 2 diabetes.RESEARCH DESIGN AND METHODS -The study comprised 173 participants with type 1 diabetes, 834 participants with type 2 diabetes, and 1,294 nondiabetic participants, aged 45-64 years at baseline and free of CVD. The age of onset of diabetes was Ͼ30 years in both diabetic groups.RESULTS -During an 18-year follow-up, 86 participants with type 1 diabetes, 567 participants with type 2 diabetes, and 252 nondiabetic participants died. CVD mortality rates per 1,000 person-years were 23.1 (95% CI 16.9 -31.9) in type 1 diabetic, 35.3 (30.8 -40.4) in type 2 diabetic, and 4.6 (3.8 -5.7) in nondiabetic participants. Adjusted hazard ratios for CVD mortality in participants with type 1 diabetes versus no diabetes was 3.6 (95% CI 2.2-5.7) in men and 13.3 (6.9 -22.5) in women and in participants with type 2 diabetes versus no diabetes 3.3 (2.5-4.5) in men and 10.1 (6.7-17.4) in women. An increment of 1 unit (%) of GHb increased CVD mortality by 52.5% (95% CI 28.4 -81.3) in type 1 diabetic subjects and by 7.5% (4.3-10.8) in type 2 diabetic participants.CONCLUSIONS -The impact of type 1 and type 2 diabetes on CVD mortality was similar. The effect of increasing hyperglycemia on the risk of CVD mortality was more profound in type 1 than in type 2 diabetic subjects.

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Section: -Total and Cvd Mortality During 18 Years Of Follow-up In Typcontrasting

confidence: 86%

Similarity of the Impact of Type 1 and Type 2 Diabetes on Cardiovascular Mortality in Middle-Aged Subjects

et al. 2008

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“…Intensive insulin therapy is important in avoiding diabetesrelated microvascular and macrovascular complications [1], but may also have a role in preserving residual beta cell function [2]. Levels of C-peptide are now being increasingly recognised as a primary endpoint in intervention trials in patients with newly diagnosed type 1 diabetes [3].…”

Section: Introductionmentioning

confidence: 99%

Sensor-augmented pump therapy from the diagnosis of childhood type 1 diabetes: results of the Paediatric Onset Study (ONSET) after 12 months of treatment

et al. 2010

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Aims/hypothesis The value of managing children with type 1 diabetes using a combination of insulin pump and continuous glucose monitoring starting from diagnosis for improving subsequent glycaemic control and preserving residual beta cell function was determined. Methods A total of 160 children (aged 1-16 years, mean± SD: 8.7±4.4 years; 47.5% girls) were randomised to receive insulin pump treatment with continuous glucose monitoring or conventional self-monitoring blood glucose measurements. The primary outcome was the level of HbA 1c after 12 months. Other analyses included fasting C-peptide, glycaemic variability, sensor usage, adverse events, children's health-related quality of life and parent's wellbeing. Results HbA 1c was not significantly different between the two groups, but patients with regular sensor use had lower values (mean 7.1%, 95% CI 6.8-7.4%) compared with the combined group with no or low sensor usage (mean 7.6%, 95% CI 7.3-7.9%; p=0.032). At 12 months, glycaemic variability was lower in the sensor group (mean amplitude of glycaemic excursions 80.2 ± 26.2 vs 92.0 ± 33.7; p=0.037). Higher C-peptide concentrations were seen in sensor-treated 12-to 16-year-old patients (0.25±0.12 nmol/l) Electronic supplementary material The online version of this article

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“…4 Finally, the importance of glycaemic control for the type 1 DM patients has become even more relevant due to recent demonstration that more intensive glycaemic control is associated to the lower CVD development in these patients. 31,32 Besides that, there is an intrinsic relation of glycaemic control to pressure values, verified through the assessment of patients placed, for intensive treatment, in the Diabetes Control and Complication Trial. 33 It was demonstrated that the better glycaemic control of type 1 DM patients is capable of preventing HPT.…”

Section: Discussionmentioning

confidence: 99%

Caracterização de pacientes com diabetes mellitus tipo 1 do sul do Brasil: complicações crônicas e fatores associados

Rodrigues

Pecis²,

Canani

et al. 2010

Rev. Assoc. Med. Bras.

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Objective. To evaluate the prevalence of chronic vascular complications and associated factors in patients with type 1 diabetes mellitus (DM 1.0, CI95%: 1.0-1.01, P = 0.05]. Seven patients had macrovascular disease. Only 22% achieved an HbA1c of <7.0%. HPT prevalence was 33%, and 48% had blood pressure levels <130/80 mmHg and 45% of the patients had LDL values > 100 mg/dl. cOnclusiOn. We observed a high prevalence of microvascular complications and HPT. The duration of DM, HPT and presence of DN were associated with DR. HPT and dyslipidemia were associated with DN. Most patients did not meet the desired glycaemic control, blood pressure and lipid targets. Greater efforts are needed to intensify the pressure and metabolic control of patients with type 1 DM.

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Changes in glycaemic control and risk of coronary artery disease in type 1 diabetes mellitus: findings from the Pittsburgh Epidemiology of Diabetes Complications Study (EDC)

Cited by 98 publications

References 32 publications

Similarity of the Impact of Type 1 and Type 2 Diabetes on Cardiovascular Mortality in Middle-Aged Subjects

Similarity of the Impact of Type 1 and Type 2 Diabetes on Cardiovascular Mortality in Middle-Aged Subjects

Sensor-augmented pump therapy from the diagnosis of childhood type 1 diabetes: results of the Paediatric Onset Study (ONSET) after 12 months of treatment

Caracterização de pacientes com diabetes mellitus tipo 1 do sul do Brasil: complicações crônicas e fatores associados

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