Atherosclerosis Begins Early in Type 1 Diabetes Patients

Study shows that atherosclerosis, begins early and that it relates to abnormalities of lipids and to diabetes complications. New study findings provide more evidence that atherosclerosis begins early in young persons with type 1 diabetes and underscore the need to monitor BP and lipid levels in adolescents with the disease.

California-based researchers measured carotid artery intima-media thickness (IMT), a marker of subclinical atherosclerosis, in 142 type 1 diabetics between 12 and 25 years of age and 87 age-matched non-diabetic controls. They also measured fasting lipid and homocysteine levels, BP, BMI and degree of glycemic control in the diabetic subjects.

The mean carotid IMT was greater in diabetic than in non-diabetic subjects (p = 0.002) across both sexes and correlated with the severity of diabetes, marked by the presence of diabetes complications, researchers report in the October issue of the Journal of Pediatrics.

Diabetics with hypertension, retinopathy, or microalbuminuria had significantly thicker carotid IMT than did subjects who did not have these complications.

In male but not female diabetic subjects, researchers noted a significant negative correlation between carotid IMT and HDL cholesterol and a significant positive correlation between carotid IMT and the LDL/HDL ratio.

"Cardiovascular disease is the leading cause of morbidity and mortality in people with diabetes, and atherosclerosis is the underlying foundation of cardiovascular disease," co-author Dr. Wendy J. Mack from the University of Southern California in Los Angeles noted in comments to Reuters Health.

"Our study shows that atherosclerosis, begins early and that it relates to abnormalities of lipids and to diabetes complications," she said.

"Providers of diabetes care for children and youth," she added, "need to begin to monitor lipids and consider interventions according to the standards of care for diabetes in children to help avert cardiovascular disease in the future."

J Pediatr 2004;145:452-457.

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FACT:

The Diabetes Prevention Program (DPP) showed that intensive lifestyle intervention reduced the risk of diabetes by 58%. Demographic, psychosocial, and behavioral factors played a large role in achieving weight loss and physical activity goals in the DPP lifestyle participants.