Cardiovascular Risk Models Inaccurate for Type 1 Diabetics

Cardiovascular risk prediction models are available for the general population and for those with type 2 diabetes. However, researchers report that these models are poor predictors of cardiovascular risk in type 1 diabetics. Dr. Janice C. Zgibor as lead investigator said that, "if health care providers use existing prediction tools to determine the risk of patients with type 1 diabetes for a coronary heart disease event, they are likely underestimating their risk."

Dr. Zgibor and colleagues at the University of Pittsburgh, Pennsylvania examined 10-year follow-up data on 658 subjects with childhood onset type 1 diabetes taking part in a prospective study of diabetes complications.

Dr. Zgibor’s group compared these findings with those generated by risk models for the general population from the US Framingham Heart Study, and for type 2 diabetics using a risk model from UK Prospective Diabetes Study Risk Engine.
The team found that both models were poor predictors of the risk of a coronary heart disease event and "expected probabilities differed significantly for both hard and total coronary heart disease outcomes." In particular, both models underestimated the probability of events in those at highest risk.

The use of these risk models, concluded Dr. Zgibor, "may result in undertreatment for risk factors like high blood pressure or high cholesterol, both of which have been shown to be problematic in those with type 1 diabetes."
Diabetes Care 2006;29:1860-1865.

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