Over the years, researchers have collected information on participants' heart disease risk factors, such as their cholesterol levels and smoking status, as well as their blood sugar levels. By examining these risk factors, Dr. Nathan explains, researchers have been able to discern that high blood sugar seems to be related to the development of the blood vessel narrowing process called atherosclerosis. Below, Dr. Nathan discusses how this information can help people with type 1 diabetes and how close control may reduce their heart disease risk.
Why did you decide to look at heart disease risk factors in patients with type 1 diabetes?
Heart disease remains a major cause of mortality in type 1 diabetes as it is in type 2 diabetes. And we know really very little about it. This is a disease that has its major onset during youth and adolescence. If you consider that most people of that age are not having very much heart disease, any increase in heart disease in the type 1 diabetic population will be considerable.
How is the thickness of the carotid artery wall a measure of heart disease?
The carotid artery is the major artery that takes blood to your brain. The process of atherosclerosis, which is really the thickening of vessel walls that ultimately leads to blockage of those vessels, is the underlying process of stroke as well as heart disease. It's very difficult to measure the blood vessels in the heart directly, and in most relatively healthy populations, that's not a method you can use.