medwireNews: People with type 1 diabetes have a greater risk for incident cardiovascular (CV) and renal disease than those with type 2 diabetes, suggest findings from a French nationwide observational study presented at the virtual 57th EASD Annual Meeting.
Denis Angoulvant and colleagues from the Centre Hospitalier Universitaire de Tours evaluated data from 50,623 adults with type 1 diabetes (average age 61.4 years) and 425,207 with type 2 diabetes (average age 68.6 years) who attended a French hospital in 2013 and were followed up for an average of 4.3 years.
Angoulvant reported that during 2,033,239 person–years of follow-up, the annual incidence rate in the total study population was 1.4% for myocardial infarction, 1.2% for ischemic stroke, 5.4% for heart failure, 3.4% for chronic kidney disease (CKD), 9.7% for all-cause mortality, and 2.4% for CV mortality.
When comparing age- and sex-adjusted event rates, the researchers found that people with type 1 diabetes aged over 60 years had a significant 1.2-fold higher risk for myocardial infarction than those with type 2 diabetes in the same age group.
The adjusted incidence of HF was also significantly elevated with type 1 versus type 2 diabetes for those aged 18–29 or over 60 years (1.1- to 1.4-fold increased risk), as was the risk for CKD in people aged 18–49 or over 60 years (1.1- to 2.4-fold increased risk).
The team also found that people in older age groups with type 1 diabetes had a significantly elevated mortality risk relative to those with type 2 diabetes. Specifically, the risk for all-cause mortality associated with type 1 versus type 2 diabetes was 1.1-fold higher for people aged over 60 years, while that for CV mortality was 1.1-fold higher for people aged 60–69 years.
In contrast to the other findings, the adjusted risk for ischemic stroke “did not markedly differ” among people with type 1 and type 2 diabetes, said Angoulvant.
He explained: “Although the prevalent burden of cardiovascular disease may be lower in patients with type 1 [versus] type 2 diabetes, those patients with type 1 diabetes may have a higher risk of incident myocardial infarction, heart failure, all-cause death, and cardiovascular death at middle-older ages.
“This observation highlights the need for improved prevention to reduce the burden of the surveillance.”
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