Type 1 diabetes patients face lower cardiovascular risk than Type 2 diabetes

A new study published in JSCAI has revealed a lower risk of cardiovascular events for patients with Type 1 diabetes (often called juvenile diabetes) compared to those with Type 2 diabetes. The research highlights the differences between the two types of diabetes and provides new insights that could influence future treatment approaches. 

The study's findings suggest that the cardiovascular risk associated with Type 1 diabetes is lower than previously thought, which has important implications for managing these patients. Our findings indicate that Type 1 diabetes is associated with a significantly lower risk of cardiovascular events compared to Type 2 diabetes, even after adjusting for various confounders such as age, diabetes control, and kidney function. The power of big data amplifies the results: With the enormous population included in this analysis, we were able to identify a large number of people with Type 1 diabetes and compare them to those with Type 2 diabetes, providing a comprehensive understanding of the differences in cardiovascular risk." 

Andrew M. Goldsweig, MD, MSc, FSCAI, director of cardiovascular clinical research at Baystate Medical Center in Springfield, MA

For the study, Goldsweig collaborated with Baystate pediatric endocrinologist Bracha Goldsweig, MD, to examine the Veradigm Metabolic Registry, operated in collaboration with the American College of Cardiology, which includes longitudinal records of 1.5 million individuals from over 700 facilities. The analysis identified nearly 6,000 people with Type 1 diabetes and compared their cardiovascular event rates to those of people with Type 2 diabetes. When controlling for confounders, the results showed that people with Type 1 diabetes had lower rates of myocardial infarction (MI), percutaneous coronary intervention (PCI), stroke, and limb ischemia compared to people with Type 2 diabetes. There was no significant difference in the rates of bypass surgery between the two groups.

Dr. Bracha Goldsweig emphasized the importance of distinguishing between patients with each type of diabetes to develop targeted treatment strategies: 

"Type 1 and Type 2 diabetes are fundamentally different diseases. People with Type 1 diabetes do not produce insulin, while people with Type 2 diabetes have insulin insensitivity. Our study shows that it is not appropriate to manage all people with diabetes identically, and dedicated studies for Type 1 diabetes are necessary to understand the best treatment approaches," Dr. Bracha Goldsweig said. "People with Type 1 diabetes now live normal lifespans, and it is crucial to study this population to ensure they receive the best possible care." 

This research marks the first time the Doctors Goldsweig, who are spouses, have published together, highlighting the importance of multidisciplinary collaboration. An Early Career Research Grant (ECRG) from the Society for Cardiovascular Angiography and Interventions (SCAI) supported the project. 

"We were excited to work together in this area where our fields overlap," Dr. Andrew Goldsweig said. "The support from SCAI's ECRG grant was crucial in making this research possible."