Higher RDW was closely linked to increased predicted cardiovascular risk in adults with longstanding type 1 diabetes. The study in Acta Diabetologica evaluated the association between RDW and 10-year CVD risk estimated using the ST1RE.

A retrospective analysis included 342 adults with type 1 diabetes duration greater than five years from a tertiary diabetes center electronic database. Individuals were stratified into RDW tertiles: <12.6, 12.6–13.2, and >13.2. The assessment examined demographic features, microvascular complication status, and ST1RE 10-year risk across tertiles.

Higher RDW aligned with older age and longer diabetes duration, while the prevalence of microvascular complications did not differ among groups. Predicted 10-year ST1RE risk rose progressively across tertiles, with median values of 4.5, 4.5, and 6.2 (p<0.01). In multiple linear regression, RDW was positively associated with ST1RE 10-year risk (β=1.13; 95% CI 0.57–1.70; p<0.01; R²=0.36). Logistic regression confirmed that RDW independently predicted moderate to high CVD risk (odds ratio 1.87; 95% CI 1.28–2.75; p=0.001) after adjustment for hypertension, dyslipidemia, diabetic kidney disease, body mass index, and high-sensitivity C-reactive protein.

These findings support RDW as a potential marker for cardiovascular risk stratification in type 1 diabetes. External validation is required before clinical application.