Evaluation of cardiovascular risk according to the 2019 ESC/EASD guidelines in type 1 diabetes mellitus patients: A population-based survey study.

BACKGROUND

The 2019 European Society of Cardiology and European Association for the Study of Diabetes (ESC/EASD) recommendations classified cardiovascular disease (CVD) risk in diabetes mellitus (DM) patients. The assessment and stratification of CVD risk were essential for identifying individuals with a very high risk of cardiovascular disease (CVD) and implementing glycemic control regimen with clear cardiovascular benefits. This research aim to evaluate the ratio of very high CV risk among patients with type 1 diabetes mellitus (T1DM) in mainland China.

METHODS

This was a cross-sectional screening study from Jan 01, 2020 to Dec 30, 2022. Basic information such as disease duration, body mass index (BMI), target organ damage (including atherosclerotic heart disease, impaired renal function, left ventricular hypertrophy, and retinopathy) were collected from outpatients by trained physicians. According to the 2019 ESC/EASD guidelines, we identify T1DM individuals with a "very high CVD risk" and others were categorized into the "else" group.

RESULTS

A total of 38,260 participants from 1,669 hospitals in mainland China were enrolled from 2020 to 2022, of which 54.81 % of T1DM patients were at very high CV risk category. The proportions of very high CVD risk in T1DM patients were highest in the Northeast region (72.70 %), followed by the Southwest region (69.99 %), and the Central region (54.41 %), while it was the lowest proportion in the Southern region (47.03 %). The proportion of very high CVD risk among T1DM patients increased with age and BMI, with 33.61 % in those under 35 years old, 59.57 % in those between 35 and 65 years old, and 70.80 % in those over 65 years old (P < 0.0001). Males and smokers showed an increased proportion of very high CVD risk in T1DM patients (P < 0.0001).

CONCLUSIONS

This was the largest cross-sectional screening study to assess the CVD risk in T1DM patients in mainland China. The CVD risk among Chinese DM patients has reached a critical level which may necessitate the comprehensive strategies for the control and management of CV-related risk factors, such as blood pressure, BMI, and lipids in DM patients, to effectively reduce the incidence of CVD events and death.