Type 1 diabetes management: Room for improvement.

Area of Science:

• Endocrinology
• Cardiovascular Medicine
• Diabetes Management

Background:

• Optimal management of type 1 diabetes (T1D) is crucial for preventing micro- and macrovascular complications.
• Evaluating target achievement and identifying risk factors are essential for refining T1D management strategies.

Purpose of the Study:

• To assess the achievement of glycemic, lipid, and blood pressure targets in adults with T1D.
• To identify risk factors associated with target achievement, comparing individuals with and without cardiovascular disease (CVD).

Main Methods:

• Cross-sectional data from 1737 adults with T1D across six Dutch diabetes centers in 2018.
• Defined targets: HbA1c <53 mmol/mol, LDL-c <2.6 mmol/L (no CVD) or <1.8 mmol/L (CVD), BP <140/90 mm Hg.
• Compared target achievement rates between individuals with and without CVD.

Main Results:

• Mean HbA1c was 63 mmol/mol, LDL-c was 2.67 mmol/L, and BP was 131/76 mm Hg.
• Target achievement rates were lower in individuals with CVD (e.g., HbA1c: 24% vs. 29%).
• In individuals without CVD, male sex and insulin pump use were associated with glycemic target achievement; smoking and complications were negatively associated.

Conclusions:

• Opportunities exist to improve glycemic, lipid, and blood pressure control in T1D management.
• Diabetes management strategies may need to be tailored differently for individuals with and without CVD.