Changes in cardiovascular risk factors in a type 1 diabetes population: A 3.5-year study

This study aimed to assess the prevalence of cardiovascular risk factors in a cohort of patients with type 1 diabetes attending a routine diabetic clinic, and to compare the data with those from a previous study (2003-2004). The clinic records of 218 patients with type 1 diabetes from the previous study were examined. The following were recorded: age, sex, duration of diabetes, insulin regimen, weight, body mass index, blood pressure, glycated haemoglobin (HbA1c), lipid profile, urine albumin-creatinine ratio, and the presence of micro- and macrovascular complications. Data were available from 184 (84.4%) of the original 218 patients - mean age 37.3 years (range 20-76 years), and duration of diabetes 18.4 years (4-42 years). Mean HbA1c, total cholesterol and low-density lipoprotein improved significantly between the two study periods (respectively: 9.6±1.9% vs 9.1±1.7%, p<0.01; 5.0±1.0mmol/L vs 4.4±1.1mmol/L, p<0.01; 2.8±0.8mmol/L vs 2.3±0.8mmol/L, p<0.01). However, systolic (113±19mmHg vs 122±17mmHg, p<0.01) and diastolic blood pressure (65±10mmHg vs 67±9mmHg, p<0.01) increased despite greater use of antihypertensives. It was concluded that attention to cardiovascular risk factors can result in improvements in HbA1c and lipid profile in a routine clinic. However, blood pressure levels increase and compliance with medication must be emphasised. A large proportion of patients with type 1 diabetes continue to have cardiovascular risk factors above current targets and additional strategies are required.