Report published on February 12, 2025 Journal of the Association of Cardiovascular Angiography and Intervention Dr. Andrew Goldsweig and colleagues investigated the risk of cardiovascular disease in patients with type I diabetes (T1DM) compared to patients with type 2 diabetes (T2DM). Both conditions increase the risk of cardiovascular events, but each disease works very differently. T1DM is an autoimmune disorder in which the immune system attacks the pancreas and destroys insulin-producing cells. In contrast, T2DM can occur at any age, including older adults, and is considered insulin resistant rather than deficiency. Goldsweig and colleagues measured the number of cardiovascular events that occurred in patients with T1DM or T2DM between 2017 and 22. This study determined the cardiovascular risk in T1DM patients and determined long-term health outcomes by directly comparing T1DM and T2DM.
This study included 162,027 diabetic patients registered in the National Cardiovascular Data Registry Beradime Metabolic Registry (VRM) between 2017 and 22. These patients were 46-75 years old, had no prior history of cardiac events and were in outpatient care. Of these participants, 5,823 patients (3.59%) had T1DM, and 156,204 patients (95.41%) had T2DM. The T2DM cohort was slightly older (56-75 years) and had a body mass index (BMI) (33.8 kg/m²) higher than the T1DM cohort (46-65 years, 28.4 kg/m²).
The study population characteristics were found to be significantly lower in patients with T1DM than incidence of coronary artery disease (7.6% vs. 11.8%), heart failure (1.0% vs. 4.5%), dyslipidemia (66.7% vs. 72.3%), hypertension (51.2% vs. 78.9%), and myomyopathy (1.3%). This may be due to the mechanism of disease or differences in age and BMI between cohorts.
A total of 11,096 cardiovascular events occurred during the study, including myocardial infarction (MI), stroke, coronary artery bypass graft (CABG), limb ischemia, percutaneous coronary intervention (PCI), and peripheral agitation. The T1DM cohort had a lower risk of MI (56% risk and 100% equal risk), and had lower PCI (43% risk), stroke (64% risk), and limb ischemia (57% risk) than the T2DM cohort. Second, the risk of cardiovascular events was lower in T1DM patients than in T2DM patients (63% risk). The risks of CABG and peripheral revascularization were comparable across groups. This trend persisted across all age groups (ages 46-55, 56-65, and 66-75). The cause of this pattern has not yet been established and may be of interest in future research. Key Data and Analytics Companies GlobalData Epidemiologists predict that in 2025, 1.8 million diagnosed cases of T1DM and 23.6 million T2DM will be diagnosed in the United States. T2DM patients are more likely to be obese than T1DM patients (>18% of patients), and more than 30% of patients, likely to be over 30% of patients. T1DM is not preventable, but T2DM can be prevented by maintaining a healthy weight, exercising regularly, and choosing a healthy diet.
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