Cardiovascular Risk Factors and Adherence to Cardiovascular Protection Practice Guidelines in Adults With Type 1
Houssein Madar1, Marie-Laure Lalanne-Mistrih2, Maha Lebbar3
1Montreal Clinical Research Institute, Montréal, Québec, Canada.
Canadian Journal of Diabetes
|April 14, 2023
Summary
Most people with type 1 diabetes (PWT1D) receive recommended cardiovascular protection. However, specific subgroups need more attention, and achieving key risk factor targets remains suboptimal for PWT1D.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Cardiovascular disease (CVD) is a leading cause of illness and death in people with type 1 diabetes (PWT1D).
- Assessing cardiovascular risk factors and treatment is crucial for managing PWT1D.
- The BETTER registry provides a valuable dataset for this Canadian cohort.
Purpose of the Study:
- To evaluate cardiovascular risk factors and pharmacologic treatment strategies in a large Canadian cohort of PWT1D.
- To identify subgroups of PWT1D with suboptimal adherence to treatment guidelines.
- To determine the extent of target achievement for key cardiovascular risk factors.
Main Methods:
- Cross-sectional study utilizing data from 974 adult PWT1D in the BETTER registry.
- Self-reported data on CVD risk factors, diabetes complications, and treatments via online questionnaires.
- Objective data available for a subset (23%) of participants.
Main Results:
- A significant proportion of PWT1D reported high cardiovascular risk (67.2%) and multiple risk factors (27.2%).
- While most received guideline-recommended care, 3 subgroups showed lower adherence to Diabetes Canada Clinical Practice Guidelines (DC-CPG).
- Only 24.5% of participants with recent lab data achieved both A1C and LDL cholesterol targets.
Conclusions:
- Most PWT1D benefit from recommended pharmacologic cardiovascular protection.
- Specific subgroups, including those with microvascular complications or longer diabetes duration, require targeted interventions.
- Suboptimal achievement of A1C and LDL cholesterol targets highlights the need for improved risk factor management in PWT1D.
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