Fariba Ahmadizar1, Patrick Souverein1, Anthonius de Boer1, Anke H Maitland-van der Zee1,2. 1. Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands. 2. Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Abstract
AIMS: The aims of the present study were, firstly, to evaluate long-term trends in the occurrence and treatment of cardiovascular disease (CVD) risk factors and the occurrence of CVD events in children with type 1 diabetes mellitus (T1DM) and, secondly, to assess the determinants of undertreatment of CVD risk factors. METHODS: A retrospective cohort study was conducted in 3728 children (<19 years of age) with T1DM and up to 5 age- and gender-matched diabetes-free children (reference cohort) (n = 18 513) using data from the Clinical Practice Research Datalink (CPRD). RESULTS: Compared with diabetes-free subjects, children with T1DM had significantly higher annual prevalence rates of CVD risk factors and cardiovascular (CV) medication use 20 years after the onset of diabetes (index date): hypertension: 35.2% vs. 11.4%, P < 0.001; hypercholesterolaemia: 66.7% vs. 7.14%, P < 0.001; and CV medication use: 37.0% vs. 3.6%, P < 0.001. The significant differences between prevalence rates in the two cohorts started from 1 year before the index date. Furthermore, 50% of the children in the T1DM cohort with hypertension and 53% with hypercholesterolaemia remained untreated with CV drugs for a period of 2-5 years during the 20-year follow-up. Age was the only determinant associated with undertreated hypertension in the T1DM cohort. CONCLUSIONS: Children with T1DM had substantially higher prevalence rates of hypertension and hypercholesterolaemia from 1 year before up to 20 years after the onset of diabetes compared with nondiabetics. There is a substantial undertreatment of CVD risk factors with CV drugs. In children with T1DM, screening for CVD risk factors and adequate treatment are of the utmost importance to prevent CVD later in life.
AIMS: The aims of the present study were, firstly, to evaluate long-term trends in the occurrence and treatment of cardiovascular disease (CVD) risk factors and the occurrence of CVD events in children with type 1 diabetes mellitus (T1DM) and, secondly, to assess the determinants of undertreatment of CVD risk factors. METHODS: A retrospective cohort study was conducted in 3728 children (<19 years of age) with T1DM and up to 5 age- and gender-matched diabetes-freechildren (reference cohort) (n = 18 513) using data from the Clinical Practice Research Datalink (CPRD). RESULTS: Compared with diabetes-free subjects, children with T1DM had significantly higher annual prevalence rates of CVD risk factors and cardiovascular (CV) medication use 20 years after the onset of diabetes (index date): hypertension: 35.2% vs. 11.4%, P < 0.001; hypercholesterolaemia: 66.7% vs. 7.14%, P < 0.001; and CV medication use: 37.0% vs. 3.6%, P < 0.001. The significant differences between prevalence rates in the two cohorts started from 1 year before the index date. Furthermore, 50% of the children in the T1DM cohort with hypertension and 53% with hypercholesterolaemia remained untreated with CV drugs for a period of 2-5 years during the 20-year follow-up. Age was the only determinant associated with undertreated hypertension in the T1DM cohort. CONCLUSIONS:Children with T1DM had substantially higher prevalence rates of hypertension and hypercholesterolaemia from 1 year before up to 20 years after the onset of diabetes compared with nondiabetics. There is a substantial undertreatment of CVD risk factors with CV drugs. In children with T1DM, screening for CVD risk factors and adequate treatment are of the utmost importance to prevent CVD later in life.
Authors: Hans Ibsen; Michael H Olsen; Kristian Wachtell; Knut Borch-Johnsen; Lars H Lindholm; Carl Erik Mogensen; Björn Dahlöf; Richard B Devereux; Ulf de Faire; Frej Fyhrquist; Stevo Julius; Sverre E Kjeldsen; Ole Lederballe-Pedersen; Markku S Nieminen; Per Omvik; Suzanne Oparil; Ying Wan Journal: Hypertension Date: 2005-01-17 Impact factor: 10.190
Authors: Bimota Nambam; Stephanie N DuBose; Brandon M Nathan; Roy W Beck; David M Maahs; R Paul Wadwa; William V Tamborlane; Nicole C Foster; Kellee M Miller; Michael J Haller Journal: Pediatr Diabetes Date: 2014-10-21 Impact factor: 4.866
Authors: K Otfried Schwab; Jürgen Doerfer; Wolfgang Hecker; Jürgen Grulich-Henn; Dagobert Wiemann; Olga Kordonouri; Peter Beyer; Reinhard W Holl Journal: Diabetes Care Date: 2006-02 Impact factor: 19.112
Authors: Fariba Ahmadizar; Soulmaz Fazeli Farsani; Patrick C Souverein; Marja Mj van der Vorst; Anthonius de Boer; Anke H Maitland-van der Zee Journal: Pediatr Diabetes Date: 2015-08-11 Impact factor: 4.866
Authors: Josine C van der Heyden; Erwin Birnie; Sarah A Bovenberg; Manuel Castro Cabezas; Noëlle van der Meulen; Dick Mul; Henk J Veeze; Henk-Jan Aanstoot Journal: J Diabetes Complications Date: 2016-03-31 Impact factor: 2.852
Authors: Julie K Bower; Lawrence J Appel; Kunihiro Matsushita; J Hunter Young; Alvaro Alonso; Frederick L Brancati; Elizabeth Selvin Journal: Diabetes Care Date: 2012-03-19 Impact factor: 19.112
Authors: Sarah D de Ferranti; Ian H de Boer; Vivian Fonseca; Caroline S Fox; Sherita Hill Golden; Carl J Lavie; Sheela N Magge; Nikolaus Marx; Darren K McGuire; Trevor J Orchard; Bernard Zinman; Robert H Eckel Journal: Diabetes Care Date: 2014-08-11 Impact factor: 19.112
Authors: Elaine M Urbina; Dana Dabelea; Ralph B D'Agostino; Amy S Shah; Lawrence M Dolan; Richard F Hamman; Stephen R Daniels; Santica Marcovina; R Paul Wadwa Journal: Diabetes Care Date: 2013-04-05 Impact factor: 19.112
Authors: Grace Kim; Daniel DeSalvo; Danielle Guffey; Charles G Minard; Constance Cephus; Douglas Moodie; Sarah Lyons Journal: Int J Pediatr Endocrinol Date: 2020-06-11