Glycemic Control and Cardiovascular Disease in 7,454 Patients With Type 1 Diabetes

• DOI: 10.2337/dc10-0398
• Publication Date: 2010-04-28T02:02:01Z
• Authors: Katarina Eeg-Olof...; Jan Cederholm; Peter M. Nilsson; Björn Zethelius; Ann-Marie Svensson; Soffia Gudbjörnsd...; Björn Eliasson
• Keywords: Albuminuria

OBJECTIVE We assessed the association between A1C and cardiovascular diseases (CVDs) in an observational study of patients with type 1 diabetes followed for 5 years. RESEARCH DESIGN AND METHODS A total 7,454 were studied from Swedish National Diabetes Register (aged 20–65 years, duration 1–35 2002 to 2007). RESULTS Hazard ratios (HRs) fatal/nonfatal coronary heart disease (CHD) per 1% unit increase baseline or updated mean at Cox regression analysis 1.31 1.34 1.26 1.32, respectively, CVD (all P < 0.001 after adjustment age, sex, duration, blood pressure, LDL cholesterol, triglycerides, BMI, smoking, history CVD). HRs only slightly lower CHD (P = 0.002) 0.002–0.007) also adjusting albuminuria. Adjusted 5-year event rates increased progressively higher A1C, ranging 12%, as well when subgrouped by shorter (1–20 years) longer (21–35 diabetes. group 4,186 5–7.9% (mean 7.2) showed risk reductions 41% (95% confidence intervals: 15–60) 0.005) 37% (12–55) 0.008) CVD, compared 3,268 8–11.9% 9.0), fully adjusted CONCLUSIONS This modern everyday clinical practice demonstrates increasing risks independently traditional factors, no J-shaped curves. 7.2% considerably reduced 9.0%, emphasizing a strong independent factor