Experts call for better cardiovascular disease management in patients with diabetes

Experts call for better cardiovascular disease management in patients with diabetes
Experts call for better cardiovascular disease management in patients with diabetes

HealthDay News -- Cardiovascular disease (CVD), a long-term complication of type 1 diabetes mellitus (T1DM), and its associated risk factors and modifiers need to be better managed, according to a statement in Diabetes Care.

“Management approaches to CVD reduction have been extrapolated in large part from experience in type 2 diabetes mellitus, despite the longer duration of disease in T1DM than in T2DM and the important differences in the underlying pathophysiology,” wrote Sarah D. de Ferranti, MD, MPH, of the Boston Children's Heart Foundation, and colleagues.

CVD is a long-term complication of T1DM; CVD events are more common and occur earlier than in patients without diabetes, noted the investigators. CVD presents at a younger age in T1DM than in T2DM, and also affects women at rates equal to those seen in men.

Atherosclerosis is more diffuse and concentric in T1DM, and additional studies are needed to further understand atherosclerosis in T1DM. CVD risk factors and modifiers in T1DM include age, disease duration, as well as hyperglycemia, diabetic kidney disease, dyslipidemia, hypertension, prehypertension, and unhealthy behaviors.

These risk factors should be addressed for CVD risk management. There are currently no CVD risk-prediction algorithms in widespread use for patients with T1DM. The use of novel processes and novel biomarkers on the accuracy of risk prediction is unclear in the T1DM population.

"Much work remains to be done to improve our understanding of T1DM and to help ameliorate the CVD effects of this important disease," concluded the researchers.

References

  1. De Ferranti SD et al. Diabetes Care. 2014; doi: 10.2337/dc14-1720

Disclosures: Several authors and reviewers disclosed financial ties to the pharmaceutical industry.

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