Type 1 Adults: Good Glucose Control Lowers Cardiovascular Risk

Findings from the latest study of the Joslin 50-Year Medalists were published in the Journal of Clinical Endocrinology & Metabolism.

The 50-year Medalists are individuals who have lived with type 1 diabetes at least 50 years.

“People are living longer with type 1 diabetes, and the onset of complications is taking longer,” said Hillary Keenan, Ph.D., a Joslin Diabetes Center assistant investigator and co-principal investigator on the Joslin 50-Year Medalist Study. “Good blood glucose control and exercise are important factors in reducing complications and mortality rates for these older individuals.”

The current study divided the 952 Medalists into three groups based on their date of diabetes diagnosis: those diagnosed fewer than 52 years ago, 52 to 55 years ago, and more than 55 years ago.

Except for proliferative diabetic retinopathy in the most recently diagnosed group, the study found that blood sugar control had little effect on the incidence of microvascular complications.

However, good glucose control was linked to lower levels of cardiovascular disease in those with longer disease duration. This finding is significant since 55 percent of deaths among Medalists are attributed to cardiovascular disease, compared to 32 percent among the same-age U.S. non-diabetes population.

For fear that tight glucose control could make older diabetes patients vulnerable to acute hypoglycemic (low blood sugar) episodes, some of the clinical guidelines regarding glucose control have been loosened for senior individuals. Yet, the latest Joslin findings suggest a continued need to maintain, within reason, good blood sugar control for optimal cardiovascular health.

The recent Medalist study further revealed the significance of exercise for reducing all cause mortality risk among longterm type 1 patients. Exercise was correlated with better blood sugar control, lower body weight, and lower blood pressure.

“We're big proponents of exercise,” says Keenan. “We understand the initial fears about maintaining blood glucose control during exercise. But people don't need to be scared; they just need to start their exercise with supervision. Exercise physiologists and diabetes educators can help with that.”

Source: Joslin Diabetes Center
Photo credit: Moodboard

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