Predicting vascular risk in Type 1 diabetes: stratification in a hospital based population in Scotland.
OBJECTIVE
To estimate the absolute cardiovascular risk of patients with Type 1 diabetes attending hospital diabetes clinics in Scotland and to develop a method for identifying those at highest risk, thus enabling therapy to be targeted.


METHODS
Baseline information was collected for 2136 patients with Type 1 diabetes using the Royal College of Physicians of Edinburgh Diabetes Register. These records were then linked to diagnoses of macrovascular disease in databases of the Information Statistics Division of the Common Services Agency.


RESULTS
During six to nine years of follow up 110 patients (5%) developed macrovascular disease. There were significant associations between baseline age (P < 0.00001), blood pressure (P < 0.00001), albuminuria (P < 0.0002), HbA1c (P < 0.001), cholesterol (P < 0.00001) and smoking status (P < 0.00001) with the development of macrovascular disease. A scoring system for future macrovascular risk was developed from a multivariate analysis of this data.


CONCLUSIONS
The data confirm the high vascular risk of patients with Type 1 diabetes. The relationship with age is such that those patients above 50 years require only one additional risk factor to reach such a high vascular risk that intervention is indicated. Using these data many patients between the age of 40 and 49 years are also likely to be identified to be at high risk.
Lewis
Susan
S
MacLeod
Margaret
M
McKnight
John
J
Morris
Andrew
A
Peden
Norman
N
Prescott
Robin
R
Walker
James
J
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000453:epidemiology*; D018572:Disease-Free Survival; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology
D006442:Glycated Hemoglobin