Influences of gender on cardiovascular disease risk factors in adolescents with and without type 1 diabetes

Brown, Talia L.; Maahs, David M.; Bishop, Franziska K.; Snell‐Bergeon, Janet K.; Wadwa, R. Paul

doi:10.1186/s13633-016-0026-6

Cited by 27 publications

(26 citation statements)

References 39 publications

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“…To minimize cardiometabolic risk, an intensive approach to weight management should be considered for girls with T1D who are overweight or obese during pre‐adolescence, taking into account the complex relationship with glycemic control and insulin omission as noted above. The significant differences by sex in the overall HbA1c trajectory group model (Table ), and, in the multinomial logistic regression (Table ), are consistent with a previous cross‐sectional study of sex differences in HbA1c and BMI z‐score …”

Section: Discussionsupporting

confidence: 88%

“…Most children and adolescents with type 1 diabetes (T1D) in the United States (US) do not meet the recommended hemoglobin A1c (HbA1c) target of <7.5% (58 mmol/mol), which increases their risk of developing diabetes‐related complications . Recent studies have reported that girls with T1D have worse metabolic control and complications than boys with T1D, and higher body mass index (BMI) z‐scores than boys with T1D and girls without T1D . Women with T1D have a significantly higher relative risk of cardiovascular disease (CVD) compared to men with T1D, when each are compared to their non‐diabetic counterparts .…”

Section: Introductionmentioning

confidence: 99%

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Trajectories of hemoglobin A1c and body mass index z‐score over four decades among 2 to 18 year olds with type 1 diabetes

Snell‐Bergeon

2019

Pediatr Diabetes

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Objectives:To determine trajectories of glycemic control and body mass index (BMI) z-score in a large pediatric sample with type 1 diabetes (T1D) over a 38-year period, and to evaluate sex differences and temporal changes in the prevalence of these trajectories. Methods:We conducted a longitudinal, retrospective study of 7002 2 to 18 year olds with T1D followed between 1978 and 2016 at a single center. Group-based modeling was used to identify trajectories for hemoglobin A1c (HbA1c) and BMI zscore. Multinomial logistic regression identified predictors of membership to less favorable glycemic trajectories.Results: Group-based modeling yielded 5 HbA1c trajectories. A total of 86% of the sample fell within 3 trajectories that were largely stable across childhood and adolescence, and 14% fell within 2 trajectories characterized by marked deterioration beginning in pre-adolescence. Girls were more likely to be in the HbA1c trajectory with the highest starting HbA1c and significant deterioration during adolescence, and in the highest two BMI z-score trajectories. Patients with non-white race had the highest odds of belonging to a less favorable HbA1c trajectory. Prevalence of the high stable HbA1c trajectory decreased and prevalence of the low stable HbA1c trajectory increased over the study period.Conclusions: A minority of youth with T1D experienced deterioration of glycemic control during adolescence. Girls were more likely to belong to the worst HbA1c trajectory and to BMI z-score trajectories in the overweight/obese range, which may increase cardiometabolic risk. Addressing racial/ethnic disparities in glycemic control should remain a priority. Advances in T1D management correlated with favorable shifts in HbA1c trajectory prevalence. K E Y W O R D Sbody mass index, diabetes mellitus, type 1, glycated hemoglobin A, health status disparities, models, statistical

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Trajectories of hemoglobin A1c and body mass index z‐score over four decades among 2 to 18 year olds with type 1 diabetes

Snell‐Bergeon

2019

Pediatr Diabetes

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“…Moreover, the percentage of participants with dyslipidaemic LDL and non‐HDL cholesterol levels was lower in the pump treatment group compared to the injection therapy group. In addition, it also confirmed well‐established associations of elevated lipid level, and more specifically LDL and non‐HDL cholesterol level, with female sex, age, diabetes duration, HbA 1c and BMI . The percentage of participants with an LDL cholesterol level ≥2.6 mmol/l was slightly higher (38%) than reported in other Type 1 diabetes cohorts (35% and 34.5% in studies from the USA and Norway, respectively) .…”

Section: Discussionsupporting

confidence: 80%

Lipid profile is associated with treatment regimen in a large cohort of children and adolescents with Type 1 diabetes mellitus: a study from the international SWEET database

et al. 2019

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Aims To examine the effect of pump vs injection therapy on the lipid profile of children with Type 1 diabetes mellitus.Methods A cross-sectional analysis of the lipid profile of children aged ≤ 18 years with Type 1 diabetes mellitus from SWEET, an international diabetes registry, was conducted with a focus on the effect of treatment regimen. Dyslipidaemia was defined as LDL cholesterol ≥2.6 mmol/l or non-HDL cholesterol ≥3.1 mmol/l. LDL and non-HDL cholesterol values among 14 290 children (52% boys, 51% receiving pump therapy) from 60 SWEET centres were analysed by linear and logistic regression analysis adjusted for sex, age, diabetes duration, HbA 1c and BMI-standard deviation score group, region, and common interactions between age, sex, HbA 1c and BMI.Results This study confirmed the established associations of increased lipids with female sex, age, diabetes duration, HbA 1c and BMI. LDL and non-HDL cholesterol levels were lower in the pump therapy group compared to the injection therapy group [LDL cholesterol: injection therapy 2.44 mmol/l (95% CI 2.42 to 2.46) vs pump therapy 2.39 mmol/l (95% CI 2.37-2.41), P<0.001; non-HDL cholesterol: injection therapy 2.88 mmol/l (95% CI 2.86 to 2.90) vs pump therapy 2.80 mmol/l (95% CI 2.78-2.82), both P<0.0001]. Similarly, the odds ratios for LDL cholesterol ≥2.6 mmol/l [0.89 (95% CI 0.82-0.97)] and non-HDL cholesterol ≥3.1 mmol/l [0.85 (0.78 to 0.93)] were significantly lower in the pump therapy group, even after all adjustments. ConclusionsOur results indicate that pump therapy is associated with a better lipid profile.

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“…In that study, the presence of type 1 diabetes was greatly associated with prevalence of coronary calcification in women compared to men despite similar glycemic control and higher lipids detected in men (29). Studies have reported higher HbA1c, BMI Z-scores, atherogenic lipoprotein subfractions, and insulin resistance in adolescent girls with type 1 diabetes compared to adolescent boys with the condition (30,31). Taken together, gender differences in glycemic control, BMI, or insulin resistance earlier in life (childhood and adolescence) may result in bad metabolic memory and a higher risk for cardiovascular diseases in women with type 1 diabetes as they transition to adulthood.…”

Section: Accepted Manuscriptmentioning

confidence: 82%

Gender differences in diabetes self-care in adults with type 1 diabetes: Findings from the T1D Exchange clinic registry

Shah¹,

Polsky³

et al. 2018

Journal of Diabetes and its Complications

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Influences of gender on cardiovascular disease risk factors in adolescents with and without type 1 diabetes

Cited by 27 publications

References 39 publications

Trajectories of hemoglobin A1c and body mass index z‐score over four decades among 2 to 18 year olds with type 1 diabetes

Trajectories of hemoglobin A1c and body mass index z‐score over four decades among 2 to 18 year olds with type 1 diabetes

Lipid profile is associated with treatment regimen in a large cohort of children and adolescents with Type 1 diabetes mellitus: a study from the international SWEET database

Gender differences in diabetes self-care in adults with type 1 diabetes: Findings from the T1D Exchange clinic registry

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