A new study has found that individuals with Type 1 diabetes have a lower risk of experiencing cardiovascular events, such as strokes or heart attacks, compared to those with Type 2 diabetes. This finding underscores the fundamental differences between the two conditions and offers valuable insights for future treatments.

Both Type 1 (T1D) and Type 2 diabetes (T2D) are well-established risk factors for heart disease. The metabolic abnormalities associated with these conditions contribute to atherogenesis, the buildup of plaques on artery walls. Consequently, individuals with diabetes tend to have a higher number of plaques and narrower arteries compared to those without diabetes.

Figure 1.Diabetes Type Influences Heart Attack & Stroke Risk.

Although both conditions lead to elevated blood glucose levels, Type 1 (T1D) and Type 2 diabetes (T2D) are fundamentally different. T1D results from insulin deficiency, whereas T2D is caused by insulin resistance. A recent study examined whether these distinct pathophysiological differences influence cardiovascular risk. Figure1 showsDiabetes Type Influences Heart Attack & Stroke Risk.

“Type 1 and Type 2 diabetes are fundamentally different diseases,” said Dr. Bracha Goldsweig, a pediatric endocrinologist at Baystate Medical Center in Springfield, Massachusetts, and the study’s senior author. “People with Type 1 diabetes do not produce insulin, while those with Type 2 diabetes experience insulin insensitivity [1]. Our study highlights the importance of tailoring treatment approaches rather than managing all people with diabetes the same way. Dedicated studies for Type 1 diabetes are essential to determine the most effective treatment strategies.”

Surprisingly, few studies have specifically investigated the relationship between the underlying pathology of Type 1 diabetes (T1D) and cardiovascular disease. Instead, the management of cardiovascular disease in T1D patients is often based on research conducted on individuals with Type 2 diabetes (T2D). This issue was emphasized in a joint scientific statement released by the American Heart Association and the American Diabetes Association in 2014. The researchers analyzed data from the 2017–2022 Veradigm Metabolic Registry (VMR), a longitudinal database tracking over 1.5 million patients to enhance diabetes and cardiometabolic care across the United States. The study included 5,823 individuals with Type 1 diabetes (T1D) and 156,204 with Type 2 diabetes (T2D), covering 758,643 visits to outpatient primary care and endocrinology facilities. Participants ranged in age from 46 to 75 years.

A total of 11,096 cardiovascular events were recorded among the participants. Of these, 45.3% experienced a stroke, 19.5% had limb ischemia (a severe blockage in the lower limb arteries), 17.1% underwent coronary artery bypass grafting (CABG), 17.5% suffered a heart attack (myocardial infarction), and 9.3% received a stent to open a blocked coronary artery (percutaneous coronary intervention, PCI).

After analyzing the data, researchers found that patients with Type 1 diabetes (T1D) had a lower likelihood of experiencing cardiovascular events compared to those with Type 2 diabetes (T2D). Specifically, individuals with T1D had approximately 63% of the cardiovascular risk observed in T2D patients. This reduced risk was consistent across different age groups: 64% for ages 46–55, 69% for ages 56–65, and 62% for ages 66–75, in both men and women.

When examining specific cardiovascular events, and after adjusting for confounding factors, the results showed that T1D patients had lower rates of myocardial infarction, percutaneous coronary intervention (PCI), stroke, and limb ischemia compared to those with T2D. However, no significant difference was found in coronary artery bypass surgery rates between the two groups.

“These findings suggest that the cardiovascular risk associated with Type 1 diabetes is lower than previously believed, which has important implications for patient management,” said Dr. Andrew Goldsweig, director of cardiovascular clinical research at Baystate Medical Center in Springfield, Massachusetts, and the study’s lead and corresponding author[2]. He is also married to co-author Dr. Bracha Goldsweig. “Our research indicates that Type 1 diabetes is linked to a significantly lower risk of cardiovascular events compared to Type 2 diabetes, even after accounting for factors such as age, diabetes control, and kidney function.”

"The power of big data strengthens these findings," the researchers noted. "With the vast population included in this analysis, we were able to identify a significant number of individuals with Type 1 diabetes and compare them to those with Type 2 diabetes, offering a comprehensive understanding of the differences in cardiovascular risk."

While the study suggests that individuals with Type 1 diabetes have a lower risk of cardiovascular events compared to those with Type 2 diabetes, further research is needed to deepen our understanding of the underlying pathophysiology, as well as improve prevention and treatment strategies for heart disease in T1D patients.

“People with Type 1 diabetes now live normal lifespans, making it essential to study this population to ensure they receive the best possible care,” said Dr. Bracha Goldsweig.

References

1. https://newatlas.com/heart-disease/diabetes-type-cardiovascular-event/
2. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/heart-disease-stroke

Cite this article:

Keerthana S (2025),The type of diabetes influences the risk of heart attack or stroke,AnaTechMaz,pp.335