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

Abstract

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.

Associations of Cardiorespiratory Fitness and Obesity With Risks of Impaired Fasting Glucose and Type 2 Diabetes in Men

“…T ype 2 diabetes, one of the most costly chronic diseases, is a major risk factor for cardiovascular disease (CVD) mortality (1). Impaired fasting glucose (IFG), a pre-diabetic state, is a strong predictor of type 2 diabetes and CVD (2).…”

Haemoglobin A1c levels and subsequent cardiovascular disease in persons without diabetes: a meta-analysis of prospective cohorts

“…After reading the full text, there were 26 potentially acceptable studies that were rejected at the final stage: 14 did not have appropriate data [1,[13][14][15][16][17][18][19][20][21][22][23][24][25]; four did not involve outcomes of interest [26][27][28][29]; three studied non-relevant populations [30][31][32]; three were duplicates [33][34][35]; and two were editorials/review papers [36,37]. That left seven papers for analysis [38][39][40][41][42][43][44].…”

Type 1 Diabetes Mellitus: Redefining the Future of Cardiovascular Complications with Novel Treatments

“…These cardiovascular complications are mostly focused in clinical practice to type 2 DM (Fowler, 2008), and increased in rate as well in type 1 DM (Mcphee et al, 2008); however, the mortality impact of cardiovascular diseases in both DM types 1 and 2 is similar (Juutilainen et al, 2008) contributing to 80 % of the mortality and morbidity (Coccheri, 2007). More alarmingly, development of macrovascular complication might not manifest in type 1 DM until 10 years proceeding diagnosis (King et al, 2005).…”