Blood Glucose Control Lessens Risk of Heart Disease in Type 1 Diabetes

Typically, type 1 diabetes is diagnosed during childhood. Very young patients may have trouble achieving blood glucose control and understanding how long-term glucose control can be beneficial for their health; however, implementing a healthy diet and an exercise regimen can reduce risks later in life.

The findings from a study published by the Journal of Clinical Endocrinology & Metabolism confirm the importance of blood glucose control and exercise in reducing the risk of cardiovascular complications and mortality in older patients with type 1 diabetes.

"People are living longer with type 1 diabetes, and the onset of complications is taking longer," said co-principal investigator Hillary Keenan, PhD. "Good blood glucose control and exercise are important factors in reducing complications and mortality rates for these older individuals."

The study evaluated 952 patients with type 1 diabetes included in the Joslin Diabetes Center 50-Year Medalist program. The program recognizes patients who have been living with diabetes for more than 25, 50, or 75 years.

The authors examined the health characteristics of these patients, who were divided into 3 groups based on date of diagnosis.

The finding from the team’s earlier studies suggested that blood glucose control did not significantly alter the development of macrovascular complications, including proliferative diabetic retinopathy (PDR).

In the current study, patients were grouped by diagnosis fewer than 52 years ago, 52 to 55 years ago, or more than 55 years ago. The authors found that glycemic control was observed to have little effect on the rate of microvascular complications.

However, the authors noted the exception of PDR in the most recently diagnosed group, according to the study.

The investigators also found that glycemic control was linked to a reduced level of cardiovascular disease among patients with longer disease duration, which is significant because it accounted for 55% of deaths in this population compared with 32% in the age-matched patients without diabetes, according to the study.

Guidelines regarding glycemic control in older patients with type 1 diabetes have been lessened due to concerns that strict control may result in episodes of low blood glucose and associated adverse events.

The new findings demonstrate the benefits of continued glycemic control on potentially reducing the risk of cardiovascular disease, according to the study.

The study also highlighted the benefits of exercise among this population, as it was found to lower the risk of mortality. Exercise has also been extensively linked to glycemic control, lower blood pressure, and weight loss.

"We're big proponents of exercise,” Dr Keenan said. "We understand the initial fears about maintaining blood glucose control during exercise. But people don't need to be scared; they just need to start their exercise with supervision. Exercise physiologists and diabetes educators can help with that."