Kidney Function, Glycemic Index May Predict Heart Disease Risk in Type 1 Diabetics

For those with type 1 diabetes, it is imperative that they maintain good control of their blood sugar, especially since not doing so can raise their risk of heart disease. A new study reveals that kidney function may also be an indicator of the possible development of heart disease in a type 1 diabetic patient.

A study done by the University of Pittsburgh revealed that patients with lower hemoglobin A1C levels and who exhibit signs of poor renal (kidney) function were "significantly more likely to develop coronary artery disease." The study looked specifically at the estimated glomerular filtration rate, or eGFR.

A1C levels and coronary artery disease

Researchers looked at 311 patients who had type 1 diabetes discovered in childhood. Over one-quarter of these patients went on to develop coronary artery disease. Those who had high A1C levels had nearly a 32 percent incidence of CAD, while CAD only occurred in 21 percent of those with lower A1C levels. However, both blood cell counts and hypertension rates also predicted CAD, and they found significant interaction between kidney function and hemoglobin A1C in the low blood sugar group.


Glucose control is not the only factor

In the report given at the European Association for the Study of Diabetes, David Leslie, MD, of the University of London commented:

"It appears that poor glucose control is one factor in cardiovascular disease, but when control is not the factor, then other factors such as hypertension are relevant, and, notably, kidney disease, which in itself is a combination of glucose and hypertension problems."

The reason for the study was that researchers were puzzled as to why good blood sugar control did not always lead to lower risk of heart disease. The report in Medpage Today said that the researchers of this study "explained that glycemia hasn't been a consistent predictor of coronary artery disease (CAD) in type 1 diabetes, as some patients with good glycemic control still have a higher risk of heart disease."

Sources:
http://www.medpagetoday.com/MeetingCoverage/EASD/35086 http://www.diabetes.org/living-with-diabetes/complications/kidney-diseas...



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