Type 1 diabetes, metabolic syndrome and cardiovascular risk

• Published in: Metabolism, clinical and experimental Vol. 63; no. 2; pp. 181 - 187
• Main Authors: Chillarón, Juan J, Flores Le-Roux, Juana A, Benaiges, David, Pedro-Botet, Juan
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.2014; Elsevier
• Subjects: Biological and medical sciences; Biomarkers - blood; Blood Glucose - metabolism; Cardiovascular Diseases - blood; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - prevention & control; Cardiovascular risk; Chronic complications; Diabetes Complications - blood; Diabetes Complications - epidemiology; Diabetes Complications - prevention & control; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - drug therapy; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinology & Metabolism; Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Fundamental and applied biological sciences. Psychology; Glycated Hemoglobin A - metabolism; Humans; Hypoglycemia - chemically induced; Hypoglycemia - prevention & control; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - adverse effects; Insulin - administration & dosage; Insulin - adverse effects; Insulin Resistance; Medical sciences; Metabolic diseases; Metabolic syndrome; Metabolic Syndrome - complications; Miscellaneous; Obesity - etiology; Other metabolic disorders; Risk Assessment; Risk Factors; Type 1 diabetes; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Weight Gain; T1DM; Apo; T2DM; apolipoprotein; estimated glucose disposal rate; Chronic complications; Metabolic syndrome; EASD; Diabetes Control and Complications Trial; HDL; LDL; type 2 diabetes mellitus; EDIC; type 1 diabetes mellitus; high-density lipoproteins; DCCT; Epidemiology of Diabetes Interventions and Complications trial; HOMA-IR; low-density lipoproteins; homeostasis model assessment-insulin resistance; Type 1 diabetes; Cardiovascular risk; American Diabetes Association; European Association for the Study of Diabetes; ADA; eGDR; Endocrinopathy; Immunopathology; Risk factor; Autoimmune disease; Metabolic diseases; Cardiovascular disease; Coronary heart disease; Endocrinology
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1016/j.metabol.2013.10.002

Abstract Patients with type 1 diabetes mellitus (T1DM) traditionally had a low body mass index and microangiopathic complications were common, while macroangiopathy and the metabolic syndrome were exceptional. The Diabetes Control and Complications Trial, published in 1993, demonstrated that therapy aimed at maintaining HbA1c levels as close to normal as feasible reduced the incidence of microangiopathy. Since then, the use of intensive insulin therapy to optimize metabolic control became generalized. Improved glycemic control resulted in a lower incidence of microangiopathy; however, its side effects included a higher rate of severe hypoglycemia and increased weight gain. Approximately 50% of patients with T1DM are currently obese or overweight, and between 8% and 40% meet the metabolic syndrome criteria. The components of the metabolic syndrome and insulin resistance have been linked to chronic T1DM complications, and cardiovascular disease is now the leading cause of death in these patients. Therefore, new therapeutic strategies are required in T1DM subjects, not only to intensively lower glycemia, but to control all associated metabolic syndrome traits.