Article

Journal of Cardiovascular Translational Research

, Volume 5, Issue 4, pp 446-462

First online:

Cardiovascular Disease Risk in Young People with Type 1 Diabetes

  • Janet K. Snell-BergeonAffiliated withBarbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical CenterColorado School of Public Health, University of Colorado Anschutz Medical Center Email author 
  • , Kristen NadeauAffiliated withDepartment of Pediatric Endocrinology, University of Colorado Anschutz Medical Center

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Abstract

Cardiovascular disease (CVD) is the most frequent cause of death in people with type 1 diabetes (T1D), despite modern advances in glycemic control and CVD risk factor modification. CVD risk identification is essential in this high-risk population, yet remains poorly understood. This review discusses the risk factors for CVD in young people with T1D, including hyperglycemia, traditional CVD risk factors (dyslipidemia, smoking, physical activity, hypertension), as well as novel risk factors such as insulin resistance, inflammation, and hypoglycemia. We present evidence that adverse changes in cardiovascular function, arterial compliance, and atherosclerosis are present even during adolescence in people with T1D, highlighting the need for earlier intervention. The methods for investigating cardiovascular risk are discussed and reviewed. Finally, we discuss the observational studies and clinical trials which have thus far attempted to elucidate the best targets for early intervention in order to reduce the burden of CVD in people with T1D.

Keywords

Type 1 diabetes Cardiovascular disease Subclinical atherosclerosis Adolescents Insulin resistance Inflammation Cardiovascular function Carotid intima-media thickness Physical activity Hypertension Nephropathy Cardiovascular mortality