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Highly Uncontrolled Cardiovascular Risk in Emerging Adults With Paediatric-Onset Type 1 Diabetes-A Cross-Sectional
Alena Welters1, Christina Reinauer1, Karl Otfried Schwab2
1Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Diabetes, Obesity & Metabolism
|March 16, 2026
Summary
Young adults with type 1 diabetes have a high prevalence of cardiovascular disease risk factors, with significant gaps in treatment. Early interventions are crucial to prevent long-term vascular complications in this population.
Area of Science:
- Endocrinology and Metabolism
- Cardiovascular Medicine
- Public Health
Background:
- Cardiovascular disease (CVD) is a leading cause of premature death in individuals with type 1 diabetes (T1DM).
- Glycemic control often declines during the transition from pediatric to adult care in T1DM patients.
- Identifying and managing modifiable cardiovascular risk factors is critical in young adults with T1DM.
Purpose of the Study:
- To assess the prevalence and pharmacological management of cardiovascular risk factors in adolescents and young adults with pediatric-onset T1DM.
- To examine factors associated with the burden of cardiovascular risk factors.
- To investigate the association between risk factors and early microvascular complications like retinopathy and microalbuminuria.
Main Methods:
- Analysis of data from 7298 individuals aged 17-26 years with pediatric-onset T1DM from the DPV registry (2020-2023).
- Assessment of five predefined CVD risk factors (HbA1c >9%, obesity, elevated blood pressure, LDL >130 mg/dL, smoking) using 3-year median values.
- Multivariable regression models were used to evaluate associations with cumulative risk burden and microvascular complications.
Main Results:
- Nearly half (49.2%) of individuals had at least one CVD risk factor; 19.1% had two or more.
- Poor glycemic control (HbA1c >9%) and elevated blood pressure were the most frequent risk factors.
- Significant treatment gaps were observed: only 9.9% with high LDL and 19.8% with hypertension received medication. Microalbuminuria risk increased with the number of risk factors.
Conclusions:
- Young adults with pediatric-onset T1DM exhibit a high burden of modifiable CVD risk factors and significant treatment gaps.
- The clustering of cardiovascular risk factors is associated with increased microvascular complications.
- Early identification and targeted interventions are essential to mitigate long-term vascular damage in this population.
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