Good blood sugar control essential to prevent cardiovascular disease in type 1 diabetes

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Maintaining good glucose control in type 1 diabetes is pivotal to lower the risks of cardiovascular disease and death, researchers say.
The Joslin Diabetes Center’s findings come from a study of 952 people with type 1 diabetes (known as the Joslin 50-year Medalists), who have all had the condition for at least 50 years.
All the Medalists were divided into three groups by their date of diagnosis before Joslin researchers evaluated their blood glucose control and complications status.
They found better blood glucose control was associated with a lower level of cardiovascular disease (CVD) among those with longer diabetes duration. As was expected, CVD rates were higher amongst Medalists than age-matched controls without diabetes.
“People are living longer with type 1 diabetes, and the onset of complications is taking longer,” said principal investigator Hillary Keenan, Ph.D., a Joslin Diabetes Center Assistant Investigator.
“Good blood glucose control and exercise are important factors in reducing complications and mortality rates for these older individuals.”
The Joslin team highlighted how, in the US, some clinical guidelines on blood glucose control have been loosened. This is because of concern that older people with type 1 diabetes may be more susceptible to hypoglycemia.
But they say their findings indicate vigilance needs to be continued to ensure adults and elderly people with type 1 diabetes maintain good glycemic control.
The researchers also stressed the importance of exercise in keeping CVD risks and the risk of death from all causes low. Keenan added that exercise can not only improve blood sugar levels, but also lower blood pressure and lower body weight.
“We’re big proponents of exercise. We understand the initial fears about maintaining blood glucose control during exercise. But people don’t need to be scared; they just need to start their exercise with supervision. Exercise physiologists and diabetes educators can help with that,” she said.
In the study, blood glucose control was not shown to significantly factor in the development of proliferative diabetic retinopathy (a microvascular complication).
The findings have been published in the Journal of Clinical Endocrinology and Metabolism.