Type 1 diabetes and cardiovascular disease

Schnell, Oliver; Cappuccio, Francesco P.; Genovese, Stefano; Standl, Eberhard; Valensi, P.; Ceriello, Antonio

doi:10.1186/1475-2840-12-156

Cited by 90 publications

(55 citation statements)

References 114 publications

(162 reference statements)

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“…However, in select patients, it occurs in youth early in the course of the disease ( 15 ). CAN is linked to mortality risk, as shown by a metaanalysis of 15 diff erent studies ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

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Cardiovascular Autonomic Neuropathy

McCarty

Silverman

2016

Baylor University Medical Center Proceedings

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Cardiovascular autonomic neuropathy often goes unrecognized. We present a case of a 22-year-old man with multiple manifestations of this disease, including weakness, dizziness, fatigue, tachycardia, abnormal QTc, and orthostasis, which occurred 2 years after his type 1 diabetes diagnosis. He exhibited parasympathetic denervation with resting tachycardia and exercise intolerance but also had evidence of orthostatic hypotension, which suggests sympathetic denervation. He did not have complete cardiovascular autonomic reflex testing, which would have been helpful, but improved with aggressive diabetes treatment and the increase of beta-blockade. It is important to identify these patients to understand their signs and symptoms and consider appropriate therapies. C ardiovascular autonomic neuropathy (CAN) is a serious and common complication of diabetes mellitus (DM) that is often not recognized. Diabetes mellitus aff ects more than 26 million people in the United States. Prevalence rates of CAN increase with age and duration of DM. Th e Diabetes Control and Complication Trial reported rates as high as 35% in type 1 DM and 44% in type 2 DM, with a prevalence rate of up to 60% in longstanding diabetics ( 1 ). Th e presence of CAN is associated with increased cardiovascular mortality and is the cause of cardiac dysfunction and multiple clinical symptoms, including resting tachycardia, exercise intolerance, postural hypotension, silent ischemia, cardiomyopathy, and perioperative instability ( 1 -4 ). CASE REPORTA 22-year-old African American man with a 2-year history of type 1 DM presented to the clinic with complaints of fatigue, decreased exercise tolerance, palpitations, and persistent tachycardia. He was 6' tall and 147 lb. His blood pressure and heart rate recorded supine, sitting, and standing after 3 minutes were 138/80 mm Hg/105 beats per minute (bpm), 130/88 mm Hg/122 bpm, and 98/72 mm Hg/126 bpm, respectively. His exam revealed the presence of peripheral neuropathy with numbness and tingling extending bilaterally to the shin. A Holter monitor recorded a marked decrease in his heart rate variability (HRV), with HRV of 20 bpm over each hour and an average of 118 bpm with no dipping during sleep. His thyroid function was normal. An electrocardiogram exhibited sinus

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“…However, in select patients, it occurs in youth early in the course of the disease ( 15 ). CAN is linked to mortality risk, as shown by a metaanalysis of 15 diff erent studies ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

“…Th is, in conjunction with reduced blood fl ow to nerve fi bers, contributes to the disorder ( 1 ). Myocardial blood fl ow activity in response to sympathetic stimulation is signifi cantly impaired after longstanding type 1 DM and may contribute to the eventual development of myocardial injury ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Autonomic Neuropathy

McCarty

Silverman

2016

Baylor University Medical Center Proceedings

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“…Patients with T1D have a 2-4 times greater risk of developing atherosclerosis compared to people without diabetes mellitus, and cardiovascular events account for up to 44% of the total mortality in these patients (2,(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Dyslipidemia in young patients with type 1 diabetes mellitus

Homma

Endo

Saruhashi

et al. 2015

Arch. Endocrinol. Metab.

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Objective: The association between type 1 diabetes mellitus (T1D) and dyslipidemia (DLP) increases the risk of cardiovascular disease (CVD). The aim of this study was to evaluate the presence of dyslipidemia in young T1D patients. Materials and methods: The study design was cross-sectional and descriptive. We reviewed medical records of T1D patients followed at an endocrinology service, from 1998-2012. Data collected: gender, actual age and age at diagnosis, duration of T1D since diagnosis, body mass index (BMI), pubertal stage, glycemic control (GC) determined by glycated hemoglobin (HbA1c), total cholesterol (TC), HDL, LDL, triglycerides (TG). To analyze lipid profile and metabolic control, we used the Brazilian Society of Diabetes Guidelines. Results: Were included 239 T1D patients, 136 (56.9%) females; mean ± SD: actual age 15.7 ± 5.0 years and at T1D diagnosis 7.3 ± 3.9; T1D duration 10.6 ± 6.4 years, 86.6% puberty, 15.1% overweight. The prevalence of DLP was 72.5%, 63.3% females, 86.6% puberty, mean ± SD: actual age 15.4 ± 4.8 years and at T1D diagnosis 7.2 ± 4.1 years, duration of T1D 10.7 ± 6.1 years. We found high-CT in 56.7%, low-HDL = 21.7%, high LDL = 44.0%, high-TG = 11.8%. Between females with DLP, 83.5% was in puberty. We find correlation between the presence of DLP, a poor GC and BMC. Conclusion: We found a high prevalence of DLP in young patients with T1D, particularly in puberty females. Programs targeting the prevention of dyslipidemia should be adopted, especially for this group, in order to prevent/delay chronic complications and cardiovascular disease. Arch Endocrinol Metab. 2015;59(3):215-9

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“…It was revealed that cardiovascular disease occurs in a higher rate and at a younger age among patients with T1D when compared to normal people [5]. The risk of atherosclerosis is 2 -4 times higher in T1D patients compared to people without T1D [6] [7]. The only direct correlation between T1D and cardiovascular diseases is dyslipidemia, which is the elevation of lipids e.g., triglycerides cholesterol and/or fat phospholipids in the blood [8].…”

Section: Introductionmentioning

confidence: 99%

“…The only direct correlation between T1D and cardiovascular diseases is dyslipidemia, which is the elevation of lipids e.g., triglycerides cholesterol and/or fat phospholipids in the blood [8]. The presence of dyslipidemia (DLP) significantly increases cardiovascular risk among patient with T1D [6]. Diabetic dyslipidemia is defined as low levels of high-density lipoprotein cholesterol (HDL-C) and increased low-density lipoprotein cholesterol (LDL-C) and triglycerides (TGs) [9].…”

Section: Introductionmentioning

confidence: 99%

Dyslipidemia in Kuwaiti Adolescents with Type 1 Diabetes

Otaibi¹,

Abdul-Rasool²,

Yaiesh³

et al. 2017

JDM

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Objective: Type 1 diabetes mellitus (T1D) and dyslipidemia (DLP) increase the risk of cardiovascular disease (CVD). The objective of this study was to evaluate the progress and perspective of dyslipidemia in young T1D patients . Materials and Methods: The study was cross-sectional and descriptive design. Medical records of T1D patients were followed at an endocrinology service from 2008-2014. The collected data included gender, age, duration of T1D, body mass index (BMI), glycated hemoglobin (HbA1c), total cholesterol (TC), HDL, LDL and triglycerides (TG). Results: 126 T1D patients were recruited: 69 male (54.8%) and 57 female (45.2%) with a mean of age 16.4 (±0.18) and 16.5 (±0.18), respectively. Diabetes duration and baseline HbA1c were 14.82 (±2.11) and 8.68 (±1.21), respectively. The HbA1c (average range of HbA1c 6.5% to 10.7%) increased significantly while following five years by 2.9% (p < 0.001). The prevalence of overweight and obese teens was increasing from the 1st year to the following five years later. In contrast, the underweight and healthy subjects were decreasing for the same subsequent years. Means of HbA1c were significantly higher among overweight and obese categories throughout following years. All lipid profile revealed significant increase during five years follow-up study. The prevalence of risk TC/HDL ratio (< 4.1) gradually raised in the last year follow-up by 52.1% comparing to the baseline risk ratio (0.8%). The study of TC/HDL ratio with BMI categories revealed that average T1D patients had an ideal ratio (n = 97) in the 1st year measurement. After five years follow-up study, the frequency of ideal ratio declined among all categories in the same rate. Risk TC/HDL ratio in the last year of the study showed that average group had more risk ratio measurements (n = 47) in contrast to the 1st year measurement (n = 1). The significant positive correlations were reported between HbA1c and DLP as shown in figure (r2 = 0.85). HbA1c and BMI percentile analyses during long follow-up years were How to cite this paper: Al Otaibi, F., Abdul-Rasool, M., Yaiesh, R. and Al Otaibi, N. 97very highly significant differences (p < 0.0001) between the categories BMI in each year and from one year to another. Conclusion: Attention must be given to control DLP and other comorbidities among T1D adolescents to decrease diabetes macrovascular and microvascular complications.

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Type 1 diabetes and cardiovascular disease

Cited by 90 publications

References 114 publications

Cardiovascular Autonomic Neuropathy

Cardiovascular Autonomic Neuropathy

Dyslipidemia in young patients with type 1 diabetes mellitus

Dyslipidemia in Kuwaiti Adolescents with Type 1 Diabetes

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