The risk of premature coronary artery disease (CAD) and its determinants were investigated in a cohort of 292 patients with juvenile-onset, insulin-dependent diabetes mellitus (IDDM) who were followed for 20 to 40 years. Although patients with juvenile-onset IDDM had an extremely high risk of premature CAD, the earliest deaths due to CAD did not occur until late in the third decade of life. After age 30 years, the mortality rate due to CAD increased rapidly, equally in men and women, and particularly among persons with renal complications. By age 55 years the cumulative mortality rate due to CAD was 35 +/- 5%. This was far higher than the corresponding rate for nondiabetic persons in the Framingham Heart Study, 8% for men and 4% for women. Angina and acute nonfatal myocardial infarction followed a similar pattern, as did asymptomatic CAD detected by stress test, so that their combined prevalence rate was 33% among survivors aged 45 to 59 years. Age at onset of IDDM and the presence of eye complications did not contribute to risk of premature CAD. This pattern suggests that juvenile-onset diabetes and its renal complications are modifiers of the natural history of atherosclerosis in that although they profoundly accelerate progr...Continue Reading
Associated Clinical Trials
The extramural and intramural coronary arteries in juvenile diabetes mellitus: analysis of nine necropsy patients aged 19 to 38 years with onset of diabetes before age 15 years
Risk of proliferative diabetic retinopathy in juvenile-onset type I diabetes: a 40-yr follow-up study
Platelet function during continuous insulin infusion treatment in insulin-dependent diabetic patients
Patterns of coronary heart disease morbidity and mortality in the sexes: a 26-year follow-up of the Framingham population
Abnormalities of erythrocyte deformability and platelet aggregation in insulin-dependent diabetics corrected by insulin in vivo and in vitro
Hyperglycemia and plasma lipid levels: a prospective study of young insulin-dependent diabetic patients
A prospective study of glomerular filtration rate and arterial blood pressure in insulin-dependent diabetics with diabetic nephropathy
Short term improvement in glycemic control utilizing continuous subcutaneous insulin infusion: the effect on 24-hour integrated concentrations of counterregulatory hormones and plasma lipids in insulin-dependent diabetes mellitus
Surface binding, internalization and degradation by cultured human fibroblasts of low density lipoproteins isolated from type 1 (insulin-dependent) diabetic patients: changes with metabolic control
Effect of excessive weight gain with intensive therapy of type 1 diabetes on lipid levels and blood pressure: results from the DCCT. Diabetes Control and Complications Trial
Relationship between diabetic dyslipoproteinaemia and coronary heart disease risk in subjects with non-insulin-dependent diabetes mellitus
Genetic susceptibility to nephropathy in insulin-dependent diabetes: from epidemiology to molecular genetics
Heparan sulfate proteoglycans in experimental models of diabetes: a role for perlecan in diabetes complications
Incidence of macrovascular disease in diabetes mellitus: the London cohort of the WHO Multinational Study of Vascular Disease in Diabetics
Risk factors for macrovascular disease in diabetes mellitus: the London follow-up to the WHO Multinational Study of Vascular Disease in Diabetics
Very low density lipoprotein subfraction abnormalities in IDDM patients: any effect of blood glucose control?
Ten-year cardiovascular mortality in relation to risk factors and abnormalities in lipoprotein composition in type 2 (non-insulin-dependent) diabetic and non-diabetic subjects
A prospective study of mortality among middle-aged diabetic patients (the London Cohort of the WHO Multinational Study of Vascular Disease in Diabetics) I: Causes and death rates
A prospective study of mortality among middle-aged diabetic patients (the London Cohort of the WHO Multinational Study of Vascular Disease in Diabetics) II: Associated risk factors
Echocardiographic findings in kidney transplanted type 1 (insulin-dependent) diabetic patients with and without a pancreas transplant
Adults with type 1 diabetes eat a high-fat atherogenic diet that is associated with coronary artery calcium.
Progression to microalbuminuria in type 1 diabetes: development and validation of a prediction rule.
Introduction of hyperglycemia and dyslipidemia in the pathogenesis of diabetic vascular complications
Lipoprotein composition in the insulin-deficient non-acidotic phase of type I diabetic patients and early evolution after the start of insulin therapy
Prevention of coronary heart disease in clinical practice: recommendations of the Task Force of the European Society of Cardiology, European Atherosclerosis Society and European Society of Hypertension
Urinary albumin excretion, cardiovascular disease, and endothelial dysfunction in non-insulin-dependent diabetes mellitus
The effect of diabetes mellitus on prognosis and serial left ventricular function after acute myocardial infarction: contribution of both coronary disease and diastolic left ventricular dysfunction to the adverse prognosis. The MILIS Study Group
Postprandial hypertriglyceridemia and carotid intima-media thickness in north Indian type 2 diabetic subjects
Intense lipid peroxidation in premature clinical coronary atherosclerosis is associated with metabolic abnormalities
Angiographic severity and extent of coronary artery disease in patients with type 1 diabetes mellitus
Comparison of antioxidant activity in lipoprotein fractions from insulin-dependent diabetics and healthy controls
Advanced glycosylation end products induced tissue factor expression in human monocyte-like U937 cells and increased tissue factor expression in monocytes from diabetic patients
Accelerated atherosclerosis and premature calcified cartilaginous metaplasia in the aorta of diabetic male Apo E knockout mice can be prevented by chronic treatment with 17 beta-estradiol
Are predictors of coronary heart disease and lower-extremity arterial disease in type 1 diabetes the same? A prospective study
Relationship between elastin-derived peptides and the development of microvascular complications: a longitudinal study in children with Type 1 (insulin-dependent) diabetes mellitus
Atorvastatin but not L-arginine improves endothelial function in type I diabetes mellitus: a double-blind study
Vitamin C improves endothelium-dependent vasodilation in patients with insulin-dependent diabetes mellitus
Effect of enalapril on endothelial function in young insulin-dependent diabetic patients: a randomized, double-blind study
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