Behind the headlines: Type 1 diabetes and heart disease – by Emily Burns

You might have seen the headlines today linking an early diagnosis of Type 1 diabetes to a higher risk of heart disease and a shorter life.

We know these stories can be scary. And while they shine an important light on how serious diabetes is, we want you to have the facts about what this might mean for you or your family. Our Head of Research Communications Dr Emily Burns takes a look behind the headlines.

Emily BurnsThe research

We know that heart disease is a complication of diabetes, and therefore affects people with Type 1. But this research team – across the UK and Sweden – wanted to find out if the age you’re diagnosed has an impact too.

They compared over 27,000 people with Type 1 diabetes to over 135,000 people without diabetes. They followed these people for an average of 10 years, monitoring their health.

They found that people diagnosed with Type 1 diabetes before the age of 10 were 30 times more likely to have heart complications, like a heart attack, than the general population. This dropped to a six times higher risk for people diagnosed later in life.

Women diagnosed before the age of 10 were 60 times more likely to have heart complications than women without diabetes. (We’ll explain why this is below).

They also found that this early diagnosis had an impact on the average lifespan. In the study, women diagnosed before the age of 10 had an average lifespan 17.7 years shorter than those without diabetes, and 14.2 years shorter for men. This dropped to 10 years if they were diagnosed later in life.

Those numbers can be frightening, but to put them into context we’re going to have to talk about risk.

Our top four ‘need to knows’ about risk

  1. Risk and certainty are different.

Some people win millions on the lottery. But it’s not inevitable, and the chance of it happening is affected by different factors – like how often you play.

It’s the same here: a higher risk of heart disease doesn’t mean you will develop heart disease. There are other factors involved. Which brings us to our second point.

  1. “30 times higher” sounds scary, but the overall risk is still low.

Let’s go back to the lottery analogy: if you buy 30 lottery tickets, you’re 30 times more likely to win the lottery. But it’s still *incredibly* unlikely that you’ll win.

In this study, the number of times people with Type 1 diabetes actually developed heart complications was still very small, despite the higher risk.

For example, in people diagnosed with Type 1 under the age of 10, a case of cardiovascular disease happened to roughly one in 20,000 over a 10 year period.

Bottom line is, it’s still really low. The researchers point out that this could be because people involved in the study were still quite young, and the numbers will increase with age. This is true, but we need to wait and see.

  1. This isn’t about your individual risk.

You’d be forgiven for thinking that the “30 times higher chance of heart disease” or “17.7 years shorter life” headlines apply directly to you. But that’s not the case. This was the average number in this particular group of people. Your risk is individual to you, as your journey through life is unique.

  1. You can’t compare apples to pears.

The research says that people diagnosed with Type 1 diabetes early in life are 30 times more likely to develop heart disease than people without diabetes. When broken down by sex, men were 17 times more likely and women were 60 times more likely.

Does that mean women have triple the risk that men have? Not quite, you can’t compare the two.

The research team explains that the women had a lower risk of heart complications to begin with: they’re starting at a different point. This means an early Type 1 diagnosis has a bigger impact on women. But that’s not the same as a higher overall risk of heart disease than men.

Phew! Hope you’re still with us…

Caveats aside, we know Type 1 diabetes is serious

We have to face the fact that people with diabetes are more likely to develop harmful complications, like heart or kidney disease, than people without diabetes. But why?

The researchers in this study believe the length of time a person lives with high blood glucose levels will play a role. We know that high blood glucose levels can damage blood vessels around the body, increasing the risk of complications.

The researchers also believe that people diagnosed with Type 1 diabetes very early in life might have a more aggressive form of the condition – making it even harder to hit those blood glucose targets, causing damage to blood vessels around the body.

That’s why it’s so important to keep blood glucose levels within ‘target range’ as much as possible. You can read more about that here.

 We’re doing something about it

First off, it’s important to remember the outlook for people with Type 1 diabetes has never been better than it is today. Advances in technology – like Flash and CGM – are giving people with Type 1 diabetes the best possible advances to manage their glucose levels.  There are also other ways to reduce your risk of heart complications in later life, like managing cholesterol and blood pressure levels, or getting help to stop smoking.

We’re also moving towards better, more personalised care – finding people who could most benefit from certain treatments. And research like this helps.

But the fact still remains that people with all forms of diabetes, across the world, are worried about their future. And we want to change that.

Our scientists are making progress every day, to combat heart disease and other complications of diabetes. In fact, we’re funding over £7.4 million of research right now across the UK to do just that.

From improving heart bypass surgery to following the heart and kidney health of hundreds of teenagers with Type 1 diabetes. They’re even studying the genetics of people with Type 1 diabetes to understand why complications develop.

And our research goes far beyond this. Our scientists are paving the way to a cure, working out how to replace insulin-producing cells in the pancreas and keep them safe from the immune system.

The research we fund will help us to keep on narrowing the gap between people with and without diabetes, until we ultimately reach a world where diabetes can do no harm.

We’re here for you

We hope this research helps to build evidence around who is most at risk of diabetes complications. In the future, this could help to improve guidelines for healthcare professionals, so they can provide you with the best care, and lead to more research to reduce the risk of diabetes complications.

That said, we know this kind of news is tough.

We hope this blog helps to reassure you and highlight the pioneering research we have underway to reduce the risk of complications like heart disease. And make sure everyone with diabetes lives as long and healthy a life as possible.

But if you need to talk, we’re here for you. You can reach trained counsellors on our Helpline, at helpline@diabetes.org.uk or 0345 123 2399 (Monday to Friday, 9am-6pm).

 Want more information? We’ve got you. Whatever your type of diabetes, here’s some advice on how everyone can reduce their risk of cardiovascular disease, complications more widely, and how diet is linked to your heart health.

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