Lifestyle and cardiometabolic risk in adults with type 1 diabetes: a review.
Over the past decades, there has been a major upward shift in the prevalence of cardiometabolic risk (CMR) factors (central obesity, insulin resistance, hypertension and dyslipidemia) in patients with type 1 diabetes, which could have either an additive or a synergistic effect on risk for cardiovascular disease. These metabolic changes are occurring in parallel to the worldwide obesity epidemic and the widespread use of intensive insulin therapy. Poor lifestyle habits (poor diet quality, sedentary behaviours and smoking) are known to be driving factors for increased CMR factors in the general population. The objective of this review is to explore the lifestyle habits of adults with type 1 diabetes and its potential association with CMR factors. Evidence suggests that adherence to dietary guidelines is low in subjects with type 1 diabetes with a high prevalence of patients consuming an atherogenic diet. Sedentary habits are also more prevalent than in the general population, possibly because of the additional contribution of exercise-induced hypoglycemic fear. Moreover, the prevalence of smokers is still significant in the population with type 1 diabetes. All of these behaviours could trigger a cascade of metabolic anomalies that may contribute to increased CMR factors in patients with type 1 diabetes. The intensification of insulin treatment leading to new daily challenges (e.g. carbohydrates counting, increase of hypoglycemia) could contribute to the adoption of poor lifestyle habits. Preventive measures, such as identification of patients at high risk and promotion of lifestyle changes, should be encouraged. The most appropriate therapeutic measures remain to be established.
Institut de Recherches Cliniques de Montréal, Montreal, Quebec, Canada; Department of Nutrition, Université de Montréal, Montreal, Quebec, Canada.
Catherine
C
Leroux
Institut de Recherches Cliniques de Montréal, Montreal, Quebec, Canada.
Anne-Sophie
AS
Brazeau
Institut de Recherches Cliniques de Montréal, Montreal, Quebec, Canada; Department of Nutrition, Université de Montréal, Montreal, Quebec, Canada.
Véronique
V
Gingras
Institut de Recherches Cliniques de Montréal, Montreal, Quebec, Canada; Department of Nutrition, Université de Montréal, Montreal, Quebec, Canada.
Katherine
K
Desjardins
Department of Nutrition, Université de Montréal, Montreal, Quebec, Canada; Montreal Diabetes Research Center, Montreal, Quebec, Canada; University of Montreal Hospital Research Center, Montreal, Quebec, Canada.
Irene
I
Strychar
Institut de Recherches Cliniques de Montréal, Montreal, Quebec, Canada; Department of Nutrition, Université de Montréal, Montreal, Quebec, Canada; Montreal Diabetes Research Center, Montreal, Quebec, Canada; Division of Endocrinology, Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada. Electronic address: Remi.rabasa-lhoret@ircm.qc.ca.
Rémi
R
Rabasa-Lhoret
D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000209:etiology; D016021:Epidemiologic Studies; D006801:Humans; D008019:Life Style; D012307:Risk Factors
activité physique; cardiometabolic risk; composition du régime alimentaire; diabète de type 1; diet composition; physical activity; risque cardiométabolique; smoking; tabagisme; type 1 diabetes