Cardiovascular disease (CVD) remains a major cause of premature morbidity and mortality in individuals with type 1 diabetes mellitus (T1DM). Glycemic control often worsens during the transition from pediatric to adult care, raising concern about the accumulation of cardiovascular risk factors during early adulthood.
A study published in Diabetes, Obesity, and Metabolism evaluated the prevalence and pharmacological management of modifiable CVD risk factors in adolescents and young adults with pediatric-onset T1DM. The analysis also evaluated factors associated with cumulative risk burden and the presence of early microvascular complications.
Data were analyzed from the Diabetes-Patienten-Verlaufsdokumentation (DPV) registry, including 7,298 individuals aged 17-26 years with pediatric-onset T1DM and at least 2 years of diabetes duration between 2020 and 2023. Five predefined CVD risk factors were assessed using median values over a 3-year observation period: glycated hemoglobin (HbA1c) >9%, obesity, elevated blood pressure, low-density lipoprotein (LDL) cholesterol >130 mg/dL, and smoking. Multivariable linear and logistic regression models evaluated factors associated with cumulative risk burden and microvascular complications.
At least one CVD risk factor was present in 49.2% of individuals, while 19.1% had two or more and 5.2% had three or more risk factors. Poor glycemic control (HbA1c >9%) occurred in 21.8%, and 17.6% had elevated blood pressure. Greater CVD risk factor burden was associated with diabetes duration longer than 10 years and migration background. The likelihood of microalbuminuria increased with rising risk factor burden, reaching an odds ratio (OR) of 2.68 (95% confidence interval [CI] 1.34-5.36) among individuals with four risk factors. Despite these risks, treatment gaps were evident, with medication used in 9.9% of individuals with LDL cholesterol >130 mg/dL and 19.8% of those with hypertension >140/90 mmHg.
These findings show a substantial burden of modifiable CVD risk factors in young adults with pediatric-onset T1DM, alongside notable gaps in pharmacological management.
