Young patients with type 1 diabetes have a low 10-year cardiovascular risk, but a significantly higher lifetime risk.

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Researchers say they have developed a tool to help identify patients with type 1 diabetes (T1D) early who would benefit from preventive measures to prevent heart disease, which puts them at high risk. .

This tool, called the LIFE-T1D model, was demonstrated to be able to estimate the lifetime risk of cardiovascular disease (CVD) in several groups of T1D patients. Researchers say the model has an advantage over previously tested models by providing lifetime risk estimates. Previous models relied on short-term forecast periods of up to 10 years.

“Type 1 diabetes is a nearly lifelong disease, and the majority of patients are diagnosed before age 30, so when discussing and individualizing risks and benefits for people with type 1 diabetes, very long-term estimates are important. could be more beneficial,” the group detailed.

Although younger patients may have a lower 10-year CVD risk, the risk of CVD increases with age. This means that the lifetime risk for these individuals can be “significant.”

“Lifetime risk estimates may highlight the need for early and sustained management of modifiable cardiovascular risk factors, even when short-term risks appear negligible,” the researchers wrote. writing.

The LIFE-T1D model is based on data from 39,000 Swedish patients with T1D without a history of CVD, and includes age at onset of diabetes, smoking status, and It relies on measurements such as high blood pressure. . For individuals younger than 40 years, the median lifetime risk of CVD was 69.4%, and for individuals 40 years and older, the median lifetime risk was 76%.

Over a median follow-up of approximately 12 years, 4,600 CVD events and 1,200 nonvascular deaths occurred within the cohort. The internal validation c statistic was 0.85 (95% CI; 0.84 to 0.86) for both men and women. Two gender-specific models were created to account for differences in the relative effects of different predictors and risks, including smoking, by gender.

Two additional cohorts of T1D patients from low-risk regions (2,700 in Denmark and 1,000 in the UK) were used to externally validate the model. In these groups, 168 and 155 her CVD events occurred during the 8- and 12-year follow-up periods, respectively. The validation c statistic was 0.77 (95% CI; 0.74 to 0.81) for Danish patients and 0.73 (95% CI; 0.70 to 0.77) for UK patients.

The researchers pointed out that one of the strengths of this model is that it is based on contemporary representative data. The large study population also allows for accurate predictions and generalizations.

The researchers suggest validating the model with more data sources, not just high-risk areas, to broaden its applicability. The group also noted that some factors associated with higher risk of CVD, such as socio-economic status, were not taken into account.

reference

Helming M, Hagemann S, Eliasson B, et al. Lifetime and 10-year cardiovascular risk prediction in patients with type 1 diabetes: the LIFE-T1D model. diabetes obesity meta tab. Published online March 8, 2024. doi:10.1111/dom.15531