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Type 1 diabetes mellitus and associated risk factors in patients with or without CHD: a case-control study

Journal article
Authors Anna Björk
A. M. Svensson
M. N. P. Fard
Peter J Eriksson
Mikael Dellborg
Published in Cardiology in the Young
Volume 27
Issue 9
Pages 1670-1677
ISSN 1047-9511
Publication year 2017
Published at Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 1670-1677
Language en
Links dx.doi.org/10.1017/s104795111700096...
Keywords CHD, type 1 diabetes mellitus, mortality, complications, congenital heart-disease, birth prevalence, cardiovascular-disease, scientific statement, adults, mortality, Cardiovascular System & Cardiology, Pediatrics
Subject categories Paediatric cardiology, Cardiac and Cardiovascular Systems

Abstract

Background: Approximately 1% of children are born with CHD, and 90-95% reach adulthood. Increased exposure to infections and stress-strain can contribute to an increased risk of developing type 1 diabetes mellitus. CHD may increase the risk of more serious infections, stress-strain, and increased risk of developing type 1 diabetes mellitus. Methods: We analysed the onset of and the risk of mortality and morbidity associated with concurrent CHD in patients with type 1 diabetes mellitus compared with patients with type 1 diabetes mellitus without CHD. The study combined data from the National Diabetes Register and the National Patient Register. Results: A total of 104 patients with CHD and type 1 diabetes mellitus were matched with 520 controls. Patients with CHD and type 1 diabetes mellitus had an earlier onset of diabetes (13.9 versus 17.4 years, p < 0.001), longer duration of diabetes (22.4 versus 18.1 years, p < 0.001), higher prevalence of retinopathy (64.0 versus 43.0%, p = 0.003), higher creatinine levels (83.5 versus 74.1 mu mol/L, p = 0.03), higher mortality (16 versus 5%, p = 0.002), and after onset of type 1 diabetes mellitus higher rates of co-morbidity (5.28 versus 3.18, p <= 0.01), heart failure (9 versus 2%, p = 0.02), and stroke (6 versus 2%, p = 0.048) compared with controls. Conclusions: From a nationwide register of patients with type 1 diabetes mellitus, the coexistence of CHD and type 1 diabetes mellitus was associated with an earlier onset, a higher frequency of microvascular complications, co-morbidity, and mortality.

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