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Patients With Type 1 Diabetes Have Reduced Cardiovascular Event Rates Compared With T2D
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The new data emphasize the fundamental differences in management and associated complications with each form of diabetes.
New study findings published by investigators in JSCAI demonstrate a lower risk of cardiovascular events among individuals with type 1 diabetes (T1D) compared with individuals with type 2 diabetes (T2D), emphasizing crucial differences between the conditions regarding their association with comorbidities.1,2
Image credit: VadimGuzhva | stock.adobe.comImage credit: VadimGuzhva | stock.adobe.com
"Type 1 and type 2 diabetes are fundamentally different diseases. People with type 1 diabetes do not produce insulin, while people with type 2 diabetes have insulin insensitivity," Bracha Goldsweig, MD, Baystate pediatric endocrinologist, said in a news release. "Our study shows that it is not appropriate to manage all people with diabetes identically, and dedicated studies for type 1 diabetes are necessary to understand the best treatment approaches.”2
T1D often develops suddenly and could be caused by genetics and other unknown factors, while T2D usually develops over time. Obesity and lack of exercise are known risk factors for T2D.3
“People with type 1 diabetes now live normal lifespans, and it is crucial to study this population to ensure they receive the best possible care,” Goldsweig continued.2
Both T1D and T2D are closely related to cardiovascular disease (CVD) and increase each other’s risks. According to the American Heart Association, even when glucose levels are maintained for diabetes, the risk of heart disease and stroke is still high. Conditions that contribute to the risk of developing CVD, specifically in T2D, include high blood pressure; abnormal cholesterol and high triglycerides; obesity; lack of physical activity; high blood sugar; and smoking.4
In the study, researchers used the Veradigm Metabolic Registry, which includes data from over 1.5 million individuals. The dataset featured 5823 individuals with T1D (3.59%) and 156,204 individuals with T2D (95.41%).1
Results indicated that individuals with T1D have lower rates of cardiovascular events such as heart attack, stroke, and limb ischemia compared with those with T2D. A total of 11,096 incident cardiovascular events occurred with a prevalence ratio (PR) of 0.63 (95% CI, 0.55-0.71). However, after adjusting for age, the PR was 0.66 (95% CI, 0.58-0.74).1,2
This difference was observed even after accounting for other factors that could influence cardiovascular health, according to the investigators. Despite these additional considerations, there was no difference in the rates of bypass surgery between the groups.1,2
“The study's findings suggest that the cardiovascular risk associated with type 1 diabetes is lower than previously thought, which has important implications for managing these patients," Andrew M. Goldsweig, MD, MSc, FSCAI, director of cardiovascular clinical research at Baystate Medical Center in Springfield, MA, said in a news release. "Our findings indicate that type 1 diabetes is associated with a significantly lower risk of cardiovascular events compared to type 2 diabetes, even after adjusting for various confounders such as age, diabetes control, and kidney function.”1
Despite the lower risk of cardiovascular events in patients with T1D compared with T2D observed in this trial, the underlying mechanisms, prevention strategies, and optimal treatments for cardiovascular disease among those with T1D are still not well understood.1
“With the enormous population included in this analysis, we were able to identify a large number of people with type 1 diabetes and compare them to those with type 2 diabetes, providing a comprehensive understanding of the differences in cardiovascular risk," the investigators concluded.1
