Coprogression of Cardiovascular Risk Factors in Type 1 Diabetes During 30 Years of Follow-up in the DCCT/EDIC Study

Diabetes Care. 2016 Sep;39(9):1621-30. doi: 10.2337/dc16-0502. Epub 2016 Jul 19.


Objective: The Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) study has demonstrated the beneficial effect of intensive therapy on atherosclerosis and clinical cardiovascular outcomes, while identifying hyperglycemia as a dominant risk factor for type 1 diabetes. The current analyses evaluate the extent to which glycemic exposure influences long-term changes in established risk factors for cardiovascular disease (CVD) among patients with type 1 diabetes.

Research design and methods: The DCCT study randomized 1,441 participants to receive intensive or conventional diabetes therapy; and after an average of 6.5 years of follow-up, 96% of the surviving cohort enrolled in the EDIC observational study for an additional 20 years of follow-up. Annual visits included a detailed medical history and physical examination. Blood and urine samples were collected and assayed centrally. Longitudinal models for repeated measurements were used.

Results: Higher HbA1c level was a significant correlate of the longitudinal changes in all of the traditional CVD risk factors over the 30-year follow-up. The strongest longitudinal associations were among the lipid measurements and concurrent glycemia.

Conclusions: A better understanding of the interrelationships between diabetes-related risk factors and traditional CVD risk factors may assist with the development of targeted treatment regimens for persons with type 1 diabetes who are at risk for CVD.

Trial registration: NCT00360815 NCT00360893.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Atherosclerosis / complications
  • Atherosclerosis / physiopathology*
  • Blood Glucose / metabolism
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / physiopathology*
  • Diabetes Complications / physiopathology*
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / metabolism
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Risk Factors
  • Young Adult


  • Blood Glucose
  • Hypoglycemic Agents

Associated data