Being diagnosed with type 1 diabetes at a young age is associated with more cardiovascular complications and higher risk of premature death than being diagnosed later in life, independent of disease duration.
The findings, published in The Lancet, come from a large observational study in Sweden that followed over 27,000 individuals with type 1 diabetes and more than 135,000 matched controls for an average of 10 years.
With around half of individuals with type 1 diabetes diagnosed before the age of 14, the authors are calling for the wider and earlier use of cardioprotective measures such as statins and blood pressure lowering drugs in this high-risk population.
Dr Araz Rawshani, from the University of Gothenburg in Sweden who co-led the research, said: “Although the relative risk of cardiovascular disease is increased after an early diabetes diagnosis, the absolute risk is low. However, age at disease onset appears to be an important determinant of survival as well as cardiovascular outcomes in early adulthood, warranting consideration of earlier treatment with cardioprotective drugs.”
The new estimates suggest that individuals diagnosed before the age of 10 have a 30-times greater risk of serious cardiovascular outcomes like heart attack (0.31 cases per 100,000 person years for participants with diabetes vs 0.02 cases in every 100,000 person-years for controls) and heart disease (0.5 vs 0.03) than those in the general population, whilst risk levels are around six times higher for people diagnosed between ages 26 and 30 (0.87 vs 0.25 and 1.80 vs 0.46 respectively).
People with younger-onset type 1 diabetes are four times as likely to die from any cause (0.61 vs 0.17), and have more than seven times the risk of dying from cardiovascular disease (0.09 vs 0.02) than their diabetes-free counterparts. In contrast, people first diagnosed between ages 26 and 30 face a lower (three-fold) risk of dying from any cause (1.9 vs 0.6) and cardiovascular disease (0.56 vs 0.15) compared to their peers without diabetes.