Type 1 Diabetes and Cardiovascular Risk: The Current Management Strategies

Cardiovascular disease (CVD) is the most common cause of morbidity and excess mortality in patients with diabetes. However, CVD risk varies across the different forms of diabetes mellitus owing to underlying pathobiological mechanisms. In the asymptomatic phase of prediabetes and early stages of type 2 diabetes mellitus (T2DM)-the most common form of diabetes-CVD may already be established; meanwhile, the first diagnosis of T2DM in some patients may be established only when the patients are evaluated for risk factors contributing to CVD. In contrast, type 1 diabetes mellitus (T1DM) typically presents with symptoms at the disease onset and is usually associated with a low prevalence and risk for CVD at the time of diagnosis. With good metabolic control, the CVD risk in patients with T1DM can be mitigated to some extent. While the pathophysiology and prognosis of CVD among patients with T2DM have been extensively studied and are well characterized, important uncertainties remain regarding these aspects in patients with T1DM. This clinical update review compiles the current evidence base for the evaluation and management of CVD in patients with T1DM.