3rd October 2012 - More work needs to be done to improve blood glucose control in patients with type 1 diabetes to avoid other serious health problems, experts say.
The Scottish study found that although strategies in high income countries like the UK were working, people with type 1 diabetes have two to three times the risk of heart attacks, strokes and premature death than the general population.
The risk is higher in women than men, the authors say, writing in the open access journal PLOS Medicine.
The findings come as the charity Diabetes UK publishes a prediction that the number of people in Britain with both type 1 and type 2 diabetes will rise sharply by the end of the decade.
In the latest study led the University of Dundee, researchers drew on figures from the Scottish Care Information-Diabetes Collaboration database to identify all those who were registered with type 1 diabetes aged 20 or older between 2005 and 2007. Patients were linked to any cardiovascular events and deaths using hospital databases and the death register.
They discovered that in people with type 1 diabetes the risk of having a cardiovascular event such as a heart attack or a stroke was 2.5 times higher in men and 3.2 times higher in women than in the rest of the Scottish population. Also, in those with Type 1 diabetes death rates from any cause were 2.6 times higher in men and 2.7 times higher in women than in the general population of Scotland.
Poor blood glucose control
The authors say that, worryingly, the majority of patients had poorly controlled blood glucose levels, with only 13% having HbA1c levels (a test that measures the blood sugar control over the previous three months) in the target range.
They say that there is an urgent need to understand why so few people with type 1 diabetes, such as those in the Scottish database, have good control of their blood sugar, and what can be done to improve this situation.
"Although the relative risks for cardiovascular disease and total mortality associated with type 1 diabetes in this population have declined relative to earlier studies," they say, "Type 1 diabetes continues to be associated with higher cardiovascular disease and death rates than the non-diabetic population."
"A striking feature of the data is the very low rate of achievement of glycaemic control targets."
The authors add: "Risk factor management should be improved to further reduce risk but better treatment approaches for achieving good glycaemic control are badly needed."
Commenting on the findings, Dr Iain Frame, director of research at Diabetes UK, said in a statement: “Diabetes-related complications are extremely serious and this study highlights the importance of managing blood glucose levels effectively to reduce the risk of these. It is important that people know about the seriousness of diabetes so that they can be supported by their healthcare team to take steps to manage their condition well and go on to live long and healthy lives.
“People with type 1 diabetes need the right education and support from their healthcare professionals to control their levels in a way which helps prevent health problems such as strokes, heart attacks, and ultimately early death. Everyone with diabetes should receive a minimum level of care, outlined in our 15 Healthcare Essentials, to monitor their condition and their risk of developing complications. This should be supported with advice and guidance on how to keep blood glucose levels under control."
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