Predicting vascular risk in Type 1 diabetes: stratification in a hospital based population in Scotland

Susan Lewis, James Walker, Royal College of Physicians Edinburgh Diabetes Register Group

    Research output: Contribution to journalArticle

    15 Citations (Scopus)

    Abstract

    Aims To estimate the absolute cardiovascular risk of patients with Type 1 diabetes attending hospital diabetes clinics in Scotland and to develop a method for identifying those at highest risk, thus enabling therapy to be targeted.

    Methods Baseline information was collected for 2136 patients with Type 1 diabetes using the Royal College of Physicians of Edinburgh Diabetes Register. These records were then linked to diagnoses of macrovascular disease in databases of the Information Statistics Division of the Common Services Agency.

    Results During six to nine years of follow up 110 patients (5%) developed macrovascular disease. There were significant associations between baseline age (P <0.00001), blood pressure (P <0.00001), albuminuria (P <0.0002), HbA1c (P <0.001), cholesterol (P <0.00001) and smoking status (P <0.00001) with the development of macrovascular disease. A scoring system for future macrovascular risk was developed from a multivariate analysis of this data.

    Conclusions The data confirm the high vascular risk of patients with Type 1 diabetes. The relationship with age is such that those patients above 50 years require only one additional risk factor to reach such a high vascular risk that intervention is indicated. Using these data many patients between the age of 40 and 49 years are also likely to be identified to be at high risk.

    Original languageEnglish
    Pages (from-to)164-171
    Number of pages8
    JournalDiabetic Medicine
    Volume22
    Issue number2
    DOIs
    Publication statusPublished - 2005

    Keywords

    • Type 1 diabetes
    • coronary heart disease
    • macrovascular disease
    • vascular risk
    • MELLITUS
    • SURVIVAL
    • MORTALITY
    • EVENTS
    • PRIMARY PREVENTION
    • ASSOCIATION COHORT
    • CORONARY-HEART-DISEASE

    Cite this

    Lewis, S., Walker, J., & Royal College of Physicians Edinburgh Diabetes Register Group (2005). Predicting vascular risk in Type 1 diabetes: stratification in a hospital based population in Scotland. Diabetic Medicine, 22(2), 164-171. https://doi.org/10.1111/j.1464-5491.2004.01372.x
    Lewis, Susan ; Walker, James ; Royal College of Physicians Edinburgh Diabetes Register Group. / Predicting vascular risk in Type 1 diabetes : stratification in a hospital based population in Scotland. In: Diabetic Medicine. 2005 ; Vol. 22, No. 2. pp. 164-171.
    @article{688d699f6acf4cdf8e020843a264d4d9,
    title = "Predicting vascular risk in Type 1 diabetes: stratification in a hospital based population in Scotland",
    abstract = "Aims To estimate the absolute cardiovascular risk of patients with Type 1 diabetes attending hospital diabetes clinics in Scotland and to develop a method for identifying those at highest risk, thus enabling therapy to be targeted.Methods Baseline information was collected for 2136 patients with Type 1 diabetes using the Royal College of Physicians of Edinburgh Diabetes Register. These records were then linked to diagnoses of macrovascular disease in databases of the Information Statistics Division of the Common Services Agency.Results During six to nine years of follow up 110 patients (5{\%}) developed macrovascular disease. There were significant associations between baseline age (P <0.00001), blood pressure (P <0.00001), albuminuria (P <0.0002), HbA1c (P <0.001), cholesterol (P <0.00001) and smoking status (P <0.00001) with the development of macrovascular disease. A scoring system for future macrovascular risk was developed from a multivariate analysis of this data.Conclusions The data confirm the high vascular risk of patients with Type 1 diabetes. The relationship with age is such that those patients above 50 years require only one additional risk factor to reach such a high vascular risk that intervention is indicated. Using these data many patients between the age of 40 and 49 years are also likely to be identified to be at high risk.",
    keywords = "Type 1 diabetes, coronary heart disease, macrovascular disease, vascular risk, MELLITUS, SURVIVAL, MORTALITY, EVENTS, PRIMARY PREVENTION, ASSOCIATION COHORT, CORONARY-HEART-DISEASE",
    author = "Jill Belch and Margaret Browning and Jim Campbell and Christine Carmichael and John Chalmers and Lyn Chalmers and Alan Connacher and John Doig and Ellie Dow and Mary Ferguson and Michael Fowle and David Fraser and Ann Gold and Stuart Gray and Kirstie Hanning and Victor Hawthorne and Mark Holliday and Paul Jennings and Roland Jung and Graham Leese and Margaret MacDonald and Margaret Macleod and Susan Lewis and David Matthews and Alistair McBain and Derreck McCullough and Shirley McEwan and John McKnight and Andrew Morris and Ray Newton and Alan Patrick and Norman Peden and Robin Prescott and Sheila Reith and Jan Roger and Mary Scott and Tanya Siann and Alan Smith and Christopher Thompson and James Walker and James Williamson and {Royal College of Physicians Edinburgh Diabetes Register Group}",
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    Lewis, S, Walker, J & Royal College of Physicians Edinburgh Diabetes Register Group 2005, 'Predicting vascular risk in Type 1 diabetes: stratification in a hospital based population in Scotland', Diabetic Medicine, vol. 22, no. 2, pp. 164-171. https://doi.org/10.1111/j.1464-5491.2004.01372.x

    Predicting vascular risk in Type 1 diabetes : stratification in a hospital based population in Scotland. / Lewis, Susan; Walker, James ; Royal College of Physicians Edinburgh Diabetes Register Group.

    In: Diabetic Medicine, Vol. 22, No. 2, 2005, p. 164-171.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Predicting vascular risk in Type 1 diabetes

    T2 - stratification in a hospital based population in Scotland

    AU - Belch, Jill

    AU - Browning, Margaret

    AU - Campbell, Jim

    AU - Carmichael, Christine

    AU - Chalmers, John

    AU - Chalmers, Lyn

    AU - Connacher, Alan

    AU - Doig, John

    AU - Dow, Ellie

    AU - Ferguson, Mary

    AU - Fowle, Michael

    AU - Fraser, David

    AU - Gold, Ann

    AU - Gray, Stuart

    AU - Hanning, Kirstie

    AU - Hawthorne, Victor

    AU - Holliday, Mark

    AU - Jennings, Paul

    AU - Jung, Roland

    AU - Leese, Graham

    AU - MacDonald, Margaret

    AU - Macleod, Margaret

    AU - Lewis, Susan

    AU - Matthews, David

    AU - McBain, Alistair

    AU - McCullough, Derreck

    AU - McEwan, Shirley

    AU - McKnight, John

    AU - Morris, Andrew

    AU - Newton, Ray

    AU - Patrick, Alan

    AU - Peden, Norman

    AU - Prescott, Robin

    AU - Reith, Sheila

    AU - Roger, Jan

    AU - Scott, Mary

    AU - Siann, Tanya

    AU - Smith, Alan

    AU - Thompson, Christopher

    AU - Walker, James

    AU - Williamson, James

    AU - Royal College of Physicians Edinburgh Diabetes Register Group

    PY - 2005

    Y1 - 2005

    N2 - Aims To estimate the absolute cardiovascular risk of patients with Type 1 diabetes attending hospital diabetes clinics in Scotland and to develop a method for identifying those at highest risk, thus enabling therapy to be targeted.Methods Baseline information was collected for 2136 patients with Type 1 diabetes using the Royal College of Physicians of Edinburgh Diabetes Register. These records were then linked to diagnoses of macrovascular disease in databases of the Information Statistics Division of the Common Services Agency.Results During six to nine years of follow up 110 patients (5%) developed macrovascular disease. There were significant associations between baseline age (P <0.00001), blood pressure (P <0.00001), albuminuria (P <0.0002), HbA1c (P <0.001), cholesterol (P <0.00001) and smoking status (P <0.00001) with the development of macrovascular disease. A scoring system for future macrovascular risk was developed from a multivariate analysis of this data.Conclusions The data confirm the high vascular risk of patients with Type 1 diabetes. The relationship with age is such that those patients above 50 years require only one additional risk factor to reach such a high vascular risk that intervention is indicated. Using these data many patients between the age of 40 and 49 years are also likely to be identified to be at high risk.

    AB - Aims To estimate the absolute cardiovascular risk of patients with Type 1 diabetes attending hospital diabetes clinics in Scotland and to develop a method for identifying those at highest risk, thus enabling therapy to be targeted.Methods Baseline information was collected for 2136 patients with Type 1 diabetes using the Royal College of Physicians of Edinburgh Diabetes Register. These records were then linked to diagnoses of macrovascular disease in databases of the Information Statistics Division of the Common Services Agency.Results During six to nine years of follow up 110 patients (5%) developed macrovascular disease. There were significant associations between baseline age (P <0.00001), blood pressure (P <0.00001), albuminuria (P <0.0002), HbA1c (P <0.001), cholesterol (P <0.00001) and smoking status (P <0.00001) with the development of macrovascular disease. A scoring system for future macrovascular risk was developed from a multivariate analysis of this data.Conclusions The data confirm the high vascular risk of patients with Type 1 diabetes. The relationship with age is such that those patients above 50 years require only one additional risk factor to reach such a high vascular risk that intervention is indicated. Using these data many patients between the age of 40 and 49 years are also likely to be identified to be at high risk.

    KW - Type 1 diabetes

    KW - coronary heart disease

    KW - macrovascular disease

    KW - vascular risk

    KW - MELLITUS

    KW - SURVIVAL

    KW - MORTALITY

    KW - EVENTS

    KW - PRIMARY PREVENTION

    KW - ASSOCIATION COHORT

    KW - CORONARY-HEART-DISEASE

    U2 - 10.1111/j.1464-5491.2004.01372.x

    DO - 10.1111/j.1464-5491.2004.01372.x

    M3 - Article

    VL - 22

    SP - 164

    EP - 171

    JO - Diabetic Medicine

    JF - Diabetic Medicine

    SN - 0742-3071

    IS - 2

    ER -