Taking Diabetes to Heart: An Assessment of the Early Emergence of Cardiovascular Disease and Known Risk Factors in Youth with Type 1 Diabetes

Abstract

Cardiovascular disease (CVD) is the most prevalent cause of morbidity and mortality in individuals with diabetes mellitus (DM). However, management for CVD is largely founded upon research with type 2 diabetes mellitus (T2DM) compared to other types of DM, such as type 1 diabetes mellitus (T1DM). T1DM, which is different from T2DM in terms of its pathogenesis and epidemiology, primarily affects children and adolescents. Thus, this thesis closely examines the relationship between youth-onset T1DM and the early emergence or presentation of CVD and the known risk factors. Upon providing a thorough review of the literature regarding T1DM itself and the development of CVD and its known risk factors, the thesis presents research work consisting of a retrospective cohort study on youth with T1DM in Western Australia (WA). The project investigated whether clinical and demographic characteristics at onset can independently predict the presence of known CVD risk factors within the first five years of diagnosis by utilizing binary multiple logistic regression models. The results from these models indicated that characteristics at onset, including age and year at onset, sex, socioeconomic status (SES), and baseline body mass index (BMI) z-score independently predicted the presence of these known risk factors in early life. While finer analyses are required to further understand this relationship given the limitations of the study, these findings can help inform current CVD screening guidelines and established CVD risk prediction models to enable for earlier interventions against the disease in this young population, thus mitigating their risk of developing CVD.