Cardiovascular health in adults with type 1 diabetes
Margaret M McCarthy1, Marjorie Funk2, Margaret Grey3
1College of Nursing, New York University College of Nursing, 433 First Avenue #404, New York, NY 10010, United States.
Insights
Adults with type 1 diabetes (T1D) have low achievement of ideal cardiovascular (CV) health factors, particularly glycemic control and physical activity. This highlights the need for comprehensive CV risk management in T1D care.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Type 1 diabetes (T1D) significantly increases cardiovascular (CV) disease risk.
- Effective management of CV risk factors is crucial for preventing complications in adults with T1D.
- The American Heart Association (AHA) established ideal CV health metrics.
Purpose of the Study:
- To determine the prevalence of six ideal CV health factors among adults with T1D.
- To analyze factors associated with achieving these CV health metrics within the T1D population.
Main Methods:
- Secondary analysis of data from 7153 adults in the T1D Exchange Clinic registry (2016).
- Assessed six CV health factors: hemoglobin A1c (HbA1c) <7%, body mass index (BMI) <25kg/m², blood pressure <120/80mmHg, total cholesterol <200mg/dL, non-smoking, and physical activity ≥150min/week.
- Used logistic regression to identify variables associated with achieving CV health factors.
Main Results:
- Prevalence of CV health factors ranged from 27% (HbA1c <7%) to 94% (non-smoking).
- Mean HbA1c was 7.9±1.5% and mean duration of T1D was 19.5±13.5 years.
- Gender, education, employment, and T1D duration were associated with achieving several CV health factors.
Conclusions:
- Adults with T1D exhibit suboptimal levels of key CV health factors, especially glycemic control and physical activity.
- Healthcare providers should consistently assess and guide patients on managing all CV risk factors.
- Targeted interventions are needed to improve cardiovascular health in this population.
Abstract:
Adults with type 1 diabetes (T1D) are at risk for cardiovascular (CV) disease. Managing CV risk is an important prevention strategy. The American Heart Association has defined 7 factors for ideal CV health. The purpose of this 2016 secondary analysis was to assess the prevalence of 6 CV health factors in a sample of adults ≥18 (n=7153) in the T1D Exchange Clinic registry. CV health factors include: hemoglobin A1c (HbA1c) <7%, BMI<25kg/m2, blood pressure<120/80mmHg, total cholesterol <200mg/dL, non-smoking, and physical activity ≥150min/week. HbA1c<7% was substituted for the AHA health factor of fasting blood glucose. Frequencies of each factor were tabulated for the total sample and for each gender. Logistic regression examined variables associated with achievement of each CV health factor. The mean age was 37.14±17years. Mean HbA1c was 7.9±1.5%, and duration was 19.5±13.5years. The majority (54%) were working full or part-time. Achievement of CV health factors in the whole sample ranged from 27% (HbA1c<7%) to 94% nonsmoking. Achievement of some factors varied by gender. Common variables associated with several CV health factors included gender, education, employment, and T1D duration. This young sample exhibited low levels of some CV health factors, especially HbA1c and physical activity. Providers need to routinely assess and advise on management of all CV risk factors to prevent this common diabetes complication.
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