The prevalence of modifiable cardiovascular disease (CVD) risk factors is high in children at diagnosis of type 1 diabetes (T1D), a new study published in the journal BMJ Open Diabetes Research & Care reports. In addition, the study found that increasing diabetes duration and poor glycaemic control are associated with rising levels of most risk factors.
Researchers analysed 565 children with T1D (age at diagnosis was 8.5 years; mean follow-up, 4.3 years; 48% were boys and 60% were non-white) attending routine health check-up at three East London paediatric diabetes clinics across Barts Health NHS Trust between 2005 and 2015.
CVD risk factors were present at first screening; 33.8 per cent of children were overweight or obese. The prevalence of elevated diastolic blood pressure was 20.5 per cent at diagnosis, rising to 31.7 per cent at four-year follow-up. High-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol and total cholesterol were abnormal in 22.0 per cent, 34.2 per cent and 63.5 per cent of children, respectively. Annual increases of body mass index (BMI, 0.6 kg/m2), blood pressure (BP, 0.1 standard deviation score) and lipids (0.02-0.06 mmol/L) showed a significant association with diabetes duration.
Compared with white children, black children had the greatest annual increase in BMI and systolic BP. Annual increments in lipid parameters were pronounced in Bangladeshi children.
“Our observations indicate a more focused approach to CVD prevention is required, including for those aged under 12 years. This would include prioritizing advice for a healthier approach to nutrition and exercise in addition to discussions about glycaemic control,” the authors wrote.