Browsing by Author "Bergdal, Rebecka"

Objective. Hyperglycemia and dyslipidemia are well-known risk factors for coronary artery disease (CAD) in type 1 diabetes. The impact of long-term cumulative exposure to these risk factors is less explored. We investigated the relationship between cumulative glycemic and lipid exposure and CAD in individuals with type 1 diabetes. Research Design and Methods. This longitudinal study included 3,495 adults with type 1 diabetes from the FinnDiane cohort, without end-stage kidney disease and no history of CAD or stroke at the study baseline. Total cumulative glycemic exposure (CGEtot) and cumulative hyperglycemic exposure (CGEhg), accounting only for time spent above an HbA1c of 7% (53 mmol/mol), were calculated from diabetes diagnosis. Results. During a median follow-up of 19.4 years, 534 participants had their first-ever CAD event. CGEhg (odds ratio 1.03 [95% CI 1.02-1.05], P <0.001) and cumulative exposure to LDL cholesterol, triglycerides, and non-HDL cholesterol all significantly increased the odds for incident CAD. The highest tertile of CGEhg associated with a 2-fold odds increase for incident CAD. CGEtot was not significantly associated with CAD after adjusting for cumulative lipid exposure. Conclusions. Both hyperglycemia and dyslipidemia are independently associated with CAD in type 1 diabetes. These findings emphasize the importance of reaching an HbA1c below 7% (53 mmol/mol) as well as calling on health care professionals to not settle for suboptimal glucose control, but to continue their support and encouragement towards better management of diabetes.