Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2017

Younger patients with type 1 diabetes mellitus (t1dm) have significant cardiovascular risk factors results from anda 2015 (#312)

Anthony Pease 1 2 , Natalie Nanayakkara 1 2 , Sanjeeva Ranasinha 1 , Natalie Wischer 3 , Sofianos Andrikopoulos 3 , Sophia Zoungas 1 2 4
  1. School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, 3168
  2. Diabetes and Vascular Medicine Unit, Monash Health, Clayton, VIC , 3168
  3. National Association Diabetes Centers, Sydney, NSW, Australia
  4. The George Institute for Global Health, Camperdown, NSW, Australia

Introduction

Absolute cardiovascular risk assessment is challenging for people with T1DM, especially those under 45 years of age. People with T1DM have significantly elevated life-time risk of cardiovascular disease but young age and statistical uncertainty in prediction models leads to ambiguity in setting treatment thresholds. This study considers the distribution of cardiovascular risk factors in younger and older patients with T1DM attending diabetes centres.

 

Methods

Data from the Australian National Diabetes Audit (ANDA) from 49 diabetes centres across Australia were analysed. Subjects comprised all patients with T1DM presenting to a participating Diabetes Centre during the 1-month survey period in May or June 2015. Pre-specified demographic and clinical variables were obtained. Means and standard deviations were calculated for continuous variables and frequencies (%) for categorical variables. Differences were assessed using independent t-tests and chi square tests as appropriate.

 

Results

Among the 1,248 subjects, patients <45 years compared to >45 years had a significantly higher mean (±SD) HbA1c (8.6±1.9% vs 8.4±1.6%, p= 0.044), total cholesterol level (4.8 ± 1.1mmol/L vs 4.6 ± 1.1mmol/L, p <0.001) and low density lipoprotein cholesterol level (2.7 ± 0.9mmo/L vs 2.3 ± 0.9mmol/L, p <0.001).  In contrast, systolic blood pressure (119.1 ± 15.1 mmHg vs 131.9 ± 17.9 mmHg) and BMI (26.1 ± 6.2 vs 27.7 ± 6.6 kgm2) were lower and smoking less prevalent (30.3% vs 48.1%) among the younger compared to older patients (Table 1).

 

Conclusion

Younger patients with T1DM have poorer glycaemic control and lipids levels than older patients. A large proportion of both younger and older patients continue to smoke. Given the increased life-time cardiovascular risk of patients with T1DM, strategies to optimise management of these risk factors are urgently required.

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