People with type 1 diabetes are at higher risk for heart disease, but the relationship between risk factors and type 1 diabetes is not well understood.
Last month, the American Diabetes Association and the American Heart Association released a Scientific Statement that focused on cardiovascular (heart) disease in people with type 1 diabetes, plus areas where more research is needed. These included:
- the basis for diabetes and heart disease;
- predicting future risk of heart disease in people with type 1 diabetes; and
- treating people with type 1 diabetes safely and effectively
For the most part, cardiovascular disease occurs earlier in patients with type 1 diabetes than in people without diabetes—often after they’ve been living with diabetes for about two decades.
Experts are now looking more closely on the impact of blood glucose lipids (fats), kidney function and blood pressure on cardiovascular disease. The Scientific Statement says it is important to try to achieve targets for these cardiovascular disease risk factors:
| Risk Factor | Screening/Timing | Target | Actions |
|---|---|---|---|
| High blood glucose | A1C every 3 months | Most adults: 7% or less Youth (age 13-19): less than 7.5% Youth (age 6-12): less than 8% Youth (age 0-6): less than 8.5% |
Monitor blood glucose and talk to your provider about insulin doses. |
| Kidney disease | Yearly beginning 5 years after diagnosis | For people with kidney disease, keep blood pressure less than 130/80 (adults) or less than 90th percentile (children) and take any prescribed medicine. | |
| Unhealthy blood lipid levels | Adults: every 2 years if low-risk | LDL less than 100 Non-HDL less than 130 |
Keep blood glucose levels under control and eat a diet low in saturated fat. |
| Adults without heart disease: talk to provider | LDL less than 100 | Take statins, keep blood glucose levels under control and eat diet low in saturated fat. | |
| Adults with heart disease: talk to provider | LDL less than 70 | Take statins, keep blood glucose levels under control and eat a low saturated fat diet. | |
| Children (age 10-21): once every 3 to 5 years | LDL less than 100 Non-HDL less than 130 |
Consider statins if LDL is 100 or higher. Statins are recommended if LDL is 160 or higher. Once on statins, LDL is less than 100-130. | |
| High blood pressure | Every visit | Adults: less than 140/80 – goal is less than or equal to 130/80 Children: blood pressure less than 95th percentile or 130/80 |
Eat more vegetables and fruits and less salt. Exercise almost every day. Take any blood pressure medicines as prescribed. |
| Borderline high blood pressure | Every visit | Adults: 120-130/80-89 Children: blood pressure 90-95th percentile |
Eat more vegetables and fruits and less salt. Exercise almost every day. |
| Other prevention | Age 21 and older | Aspirin as prescribed by provider. |
Take this chart to your next appointment and talk to your provider about your targets and how you can lower your risk for heart disease. You also can visit My Health Advisor to calculate your risk for heart disease and create a personal action plan to stay healthy.
Stay tuned for more information on the care and treatment of type 1 diabetes!
Jane L. Chiang
Senior Vice President, Medical and Community Affairs
American Diabetes Association
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