Titre du document / Document title

Lipid and blood pressure treatment goals for Type 1 diabetes: 10-year incidence data from the Pittsburgh Epidemiology of Diabetes Complications Study

Auteur(s) / Author(s)

ORCHARD Trevor J. ⁽¹⁾ ; FORREST Kimberly Y.-Z. ⁽²⁾ ; KULLER Lewis H. ⁽¹⁾ ; BECKER Dorothy J. ⁽³⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, ETATS-UNIS
⁽²⁾ Department of Allied Health, Slippery Rock University of Pennsylvania, Slippery Rock, Pennsylvania, ETATS-UNIS
⁽³⁾ Department of Pediatrics, Endocrinology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, ETATS-UNIS

Résumé / Abstract

OBJECTIVE- Subjects with type 1 diabetes are at high risk for many long-term complications, including early mortality and coronary artery disease (CAD). Few data are available on which to base goal levels for two major risk factors, namely blood pressure and lipid/lipoproteins. The objective of this study was to determine at which levels of LDL and HDL cholesterol, triglycerides, and blood pressure the relative risks of type 1 diabetic complications increase significantly. RESEARCH DESIGN AND METHODS- Observational prospective study of 589 patients with childhood-onset type 1 diabetes (<17 years) aged ≥18 years at baseline; 10-year incidence of mortality, CAD, lower-extremity arterial disease, proliferative retinopathy, distal symmetric polyneuropathy, and overt nephropathy. Relative risks were determined using traditional groupings of blood pressure and lipid/lipoproteins, measured at baseline, using the lowest groupings (<100 mg/dl [2,6 mmol/l] LDL cholesterol, <45 mg/dl [1.1 mmol/l] HDL cholesterol, <100 mg/dl [1.1 mmol/l] triglycerides, <110 mmHg systolic blood pressure, and <80 mmHg diastolic blood pressure) as reference. Adjustments for age, sex, and glycemic control were examined. RESULTS - Driven mainly by strong relationships (RR range 1.8-12.1) with mortality, CAD, and overt nephropathy, suggested goal levels are as follows: LDL cholesterol <100 mg/dl (2.6 mmol/l), HDL cholesterol >45 mg/dl (1.1 mmol/l), triglycerides <150 mg/dl (1.7 mmol/l), systolic blood pressure <120 mmHg, and diastolic blood pressure <80 mmHg. Age, sex, and glycemic control had little influence on these goals. CONCLUSIONS- Although observational in nature, these data strongly support the case for vigorous control of lipid levels and blood pressure in patients with type 1 diabetes.

Revue / Journal Title

Diabetes care   ISSN 0149-5992   CODEN DICAD2 

Source / Source

2001, vol. 24, n^o6, pp. 1053-1059 (37 ref.)

Langue / Language

Anglais

Editeur / Publisher

American Diabetes Association, Alexandria, VA, ETATS-UNIS  (1978) (Revue)

Mots-clés anglais / English Keywords

Insulin dependent diabetes ; Blood pressure ; Lipemia ; Boundary value ; Microangiopathy ; Coronary heart disease ; Risk factor ; Recommendation ; Adult ; Human ; Endocrinopathy ; Immunopathology ; Autoimmune disease ; Vascular disease ; Cardiovascular disease ;

Mots-clés français / French Keywords

Diabète insulinodépendant ; Pression sanguine ; Lipémie ; Valeur limite ; Microangiopathie ; Cardiopathie coronaire ; Facteur risque ; Recommandation ; Adulte ; Homme ; Endocrinopathie ; Immunopathologie ; Maladie autoimmune ; Vaisseau sanguin pathologie ; Appareil circulatoire pathologie ;

Mots-clés espagnols / Spanish Keywords

Diabetes insulinodependiente ; Presión sanguínea ; Lipemia ; Valor límite ; Microangiopatía ; Cardiopatía coronaria ; Factor riesgo ; Recomendación ; Adulto ; Hombre ; Endocrinopatía ; Inmunopatología ; Enfermedad autoinmune ; Vaso sanguíneo patología ; Aparato circulatorio patología ;

Localisation / Location

INIST-CNRS, Cote INIST : 18054, 35400009890857.0160