title: Type 1 diabetes, metabolic syndrome and cardiovascular risk.
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.
authors.affiliation: Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona; Institut Municipal d´Investigacions Mèdiques; Departament de Medicina, Universitat Autònoma de Barcelona. Electronic address: JChillaron@parcdesalutmar.cat.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Chillarón
authors.affiliation: Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona; Institut Municipal d´Investigacions Mèdiques; Departament de Medicina, Universitat Autònoma de Barcelona.
authors.forename: Juana A
authors.initials: JA
authors.lastname: Flores Le-Roux
authors.affiliation: Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona; Institut Municipal d´Investigacions Mèdiques; Departament de Medicina, Universitat Autònoma de Barcelona.
authors.forename: David
authors.initials: D
authors.lastname: Benaiges
authors.affiliation: Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona; Institut Municipal d´Investigacions Mèdiques; Departament de Medicina, Universitat Autònoma de Barcelona.
authors.forename: Juan
authors.initials: J
authors.lastname: Pedro-Botet
mesh_terms: D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D048909:Diabetes Complications / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000150:complications*; D009765:Obesity / Q000209:etiology; D018570:Risk Assessment; D012307:Risk Factors; D015430:Weight Gain
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: ADA; American Diabetes Association; Apo; Cardiovascular risk; Chronic complications; DCCT; Diabetes Control and Complications Trial; EASD; EDIC; Epidemiology of Diabetes Interventions and Complications trial; European Association for the Study of Diabetes; HDL; HOMA-IR; LDL; Metabolic syndrome; T1DM; T2DM; Type 1 diabetes; apolipoprotein; eGDR; estimated glucose disposal rate; high-density lipoproteins; homeostasis model assessment-insulin resistance; low-density lipoproteins; type 1 diabetes mellitus; type 2 diabetes mellitus