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Improvement of Care & Outcome

LIPIDS & BLOOD PRESSURE IN T1D

Rita Varkevisser, Dick Mul, Henk-Jan Aanstoot, Bruce Wolffenbuttel, Melanie van der Klauw

Differences in lipid and blood pressure measurements between individuals with type 1 diabetes and the general population: a cross-sectional study. BMJ Open 2023;13:e073690

People with T1D (PWDs) are at increased risk of all-cause mortality, especially cardiovascular mortality. Lipid and blood pressure (BP) management with lipid-lowering medication (LLM) and antihypertensive medication (AHM) plays an important role in cardiovascular disease (CVD) prevention. Many studies on CVD risk reduction have been in the context glycaemic control, rather than in the context of lipid and BP management, mainly in T2D. Studies assessing lipids and BP in PWDs have been done in the past, but both cardiometabolic risk management and glycaemic control have improved since then. This study, co-authored by Dick Mul and Henk-Jan Aanstoot of Diabeter, aimed to provide an update of lipid profiles and BP in various age groups and between men and women adult PWDs and to compare these to the general population.

 

This was a cross-sectional study including 2,287 PWDs from Diabeter and the UMCG and 146,822 people from the general population (Lifelines cohort). Age, sex, ethnicity, BMI, smoking behaviour, BP, total cholesterol, LDL-cholesterol, LLM use, AHM use and the presence of CVD were extracted from electronic health records.

Key findings:

  • Compared with the general population, PWDs:
    • were younger
    • had a comparable BMI
    • had a higher average BP
    • had lower total cholesterol and LDL-cholesterol levels
  • Lipids stratified for age and sex:
    • Without LLM-treatment: people from the general population showed increasing total and LDL-cholesterol levels with increasing age, whereas PWDs showed stable levels
    • With treatment: both groups showed slight decreases of total and LDL-cholesterol levels with increasing age
    • Male PWDs showed lower LDL-cholesterol levels than women, regardless of LLM treatment
  • Bloodpressure stratified for age and sex: 
    • Generally increasing with age
    • Without AHM-treatment: the youngest age groups showed the larger difference in BP between PWDs (higher) and people from the general population, in
    • With AHM-treatment: similar, but more variation among PWDs
    • These differences are mainly seen in women, regardless of LLM treatmen

 

Concluding, the authors state

"Lipid and BP measurements are not comparable between individuals with T1D and the general population and are particularly unfavourable for BP in the T1D group. There are potential sex differences in the management of LDL-cholesterol and BP.”" -

Please click here for the PubMed link.

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