Risk and protective factors for coronary atherosclerosis and myocardial dysfunction in individuals with long-duration type 1 diabetes
Authors' conclusion
Ageing people with long-duration type 1 diabetes and without DKD, but with excellent cardiometabolic management, still possess a high burden of coronary atherosclerosis. Improving hyperglycaemia and mitigating inflammation, especially osteopontin, are potentially important for the management of CVD in long-duration type 1 diabetes.
Study context
- Population
- Joslin 'Medalists': people with T1D of ≥50 yearsself-reported CVD
- Participants
- 1,038 participants
- Exposure
- Without diabetic kidney disease (DKD) vs with DKD
- Outcome
- Prevalence of DKD and CVD; CAC burden
Methodological detailsmultivariable regression analysis
- Multivariable regression analysis
Main finding
As reported in the abstract
DKD (eGFR <60 ml/min per 1.73 m²)
32%
CVD
40%
Coronary artery calcium (CAC) score, median
937
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| HbA1c association with CVDHypoglycaemia and glycaemic variability not associated | OR 1.40 | P < 0.01 |
| Osteopontin association with CVDOnly inflammatory marker associated | β 0.50 | P < 0.01 |
Cardiometabolic management
- Mean blood pressure
- 132/64 mmHg
- LDL-cholesterol
- 2.10 mmol/l
- HDL-cholesterol
- 1.69 mmol/l
- Median HbA1c
- 54.1 mmol/mol [7.1%]
Original publication
Risk and protective factors for coronary atherosclerosis and myocardial dysfunction in individuals with long-duration type 1 diabetes. Diabetologia. Published 20 August 2025. doi:10.
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