Trends in cardiovascular disease prevalence among adults with type 1 diabetes in the USA: analysis of commercial claims data, 2017–2021
Authors' conclusion
In this sample of US commercially insured adults with T1D, CVD prevalence remained stable at ~20% from 2017 to 2021. Early detection via improved screening and targeted management of comorbidities are key preventive strategies.
Study context
- Population
- Commercially insured adults ≥20 years with T1D, Merative MarketScan, USA, 2017–2021; 47% femalen=21,748 (2017) to n=13,294 (2021)
- Outcome
- Annual prevalence of CVD (MI, AF, ischemic heart disease, HF, peripheral artery disease, stroke)
- Follow-up
- 2017–2021
Methodological detailscommercial claims database, nationwide
- Commercial claims database
- Nationwide
Main finding
As reported in the abstract
CVD prevalence · 2017 to 2021
Cardiovascular disease (CVD) prevalence, 2017
18.18%
95% CI 17.77 to 18.66%
CVD prevalence, 2021
20.58%
95% CI 19.91 to 21.24%
Observational data: associations, not effects.
Further findings
CVD prevalence by age · 2021
- Aged 20-39 years
- 4.97%
- Aged 40-64 years
- 20.41%
- Aged 65+ years
- 52.94%
Age-adjusted CVD prevalence by sex
- Higher in males than females
- 21.93% vs 19.07%
Factors associated with CVD
- Hypertension (highest odds), aOR
- 3.15, 95% CI: 2.77 to 3.57
- Age, sex and all comorbidities independently associated with CVD
Original publication
Trends in cardiovascular disease prevalence among adults with type 1 diabetes in the USA: analysis of commercial claims data, 2017–2021. BMJ Open Diabetes Res Care. Published 3 December 2025. doi:10.
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