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The epidemiology
of heart disease in Type 1 diabetes is a little different for the relative risk is much
higher and often reaches 10+ fold, reflecting the relatively low mortality from heart
disease in young adults seen in the general population. As in Type 2 diabetes the gender
difference in rates seen in the general population are greatly reduced. One of the
strongest predictors of cardiovascular disease in Type 1 diabetes is the presence of
kidney disease, particularly in men. The reasons for this may include a shared genetic
predisposition to hypertension, a similarity in the pathogenetic process because athero-
and glomerular sclerosis are very similar processes pathologically. Kidney disease also
increases the levels of cardiovascular risk factors, blood pressure, fibrinogen and lipids
for example. LDL cholesterol and triglycerides and smoking increase the risks of both CVD
and kidney disease. Other risk factors include depressive symptomatology. |