Macrovascular disease and risk factors in youth with type 1 diabetes: time to be more attentive to treatment?

The Lancet. Diabetes & Endocrinology
Petter BjornstadDavid M Maahs

Abstract

Cardiovascular disease remains the leading cause of mortality in patients with type 1 diabetes. Although cardiovascular disease complications are rare until adulthood, pathology and early markers can manifest in adolescence. Whereas advances have been made in the management of microvascular complications of type 1 diabetes, similar progress in reducing macrovascular complications has not been made. The reasons for the absence of progress remain incompletely understood, but most likely relate to the long time needed for cardiovascular disease to manifest clinically and hence for risk factor management to show a clinical benefit, thus allowing inertia to prevail for diagnosis and particularly for targeting risk factors. In this Review, we summarise paediatric data on traditional and novel risk factors of cardiovascular disease, provide an overview of data from previous and current clinical trials, discuss future directions in cardiovascular disease research for paediatric patients with type 1 diabetes, and advocate for the early identification and treatment of cardiovascular disease risk factors as recommended in multiple guidelines.

Citations

Feb 21, 2019·Diabetes Technology & Therapeutics·David M MaahsShlomit Shalitin
Jun 11, 2020·Current Opinion in Pediatrics·Elżbieta Niechciał, M Loredana Marcovecchio
Jun 26, 2020·Frontiers in Endocrinology·Lara E Graves, Kim C Donaghue
Apr 19, 2019·Nature Reviews. Endocrinology·M Loredana MarcovecchioUNKNOWN Adolescent type 1 Diabetes cardio-renal Intervention Trial (AdDIT) study group
Aug 7, 2019·Therapeutic Advances in Endocrinology and Metabolism·Lara E Graves, Kim C Donaghue
Oct 28, 2019·Cardiovascular Endocrinology & Metabolism·Alicia JenkinsDavid O'Neal
Oct 27, 2020·Hypertension·Scott T ChiesaUNKNOWN Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT) Study Group
Jan 28, 2021·Nutrition, Metabolism, and Cardiovascular Diseases : NMCD·Anita MorandiClaudio Maffeis
Mar 29, 2020·Trends in Endocrinology and Metabolism : TEM·Bruno Vergès
Jun 29, 2021·Frontiers in Pediatrics·Scott T Chiesa, M Loredana Marcovecchio
Aug 13, 2021·Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association·Maria Felicia FaienzaMarco Matteo Ciccone
Aug 19, 2021·Antioxidants & Redox Signaling·Silvia GaravelliPaola de Candia
Oct 30, 2021·Diabetes, Obesity & Metabolism·Claire A RobertsonUNKNOWN ADDN Study Group

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