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Earlier onset of type 1 diabetes linked to greater heart risk, shorter life

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27,195 individuals aged 18 years and older in the Swedish National Diabetes Register who had been diagnosed with type 1 diabetes were studied

The earlier a child is diagnosed with type 1 diabetes, the greater the risk of heart disease and a life shortened by as much as 18 years, a large study suggests.

Experts had assumed those heightened risks were explained by kids living longer with the disease, but new analysis indicates that some other factor associated with onset in early childhood may also be involved, according to the report published in The Lancet.

While having to live longer with high glucose levels probably has an effect, “there is also some evidence that developing diabetes younger is associated with a more aggressive form of type 1 diabetes,” said Naveed Sattar, a professor of metabolic medicine at the University of Glasgow in the UK, who co-led the study. “We need more research to really investigate why younger diabetes is more damaging.”

The type 1 version of the disease has a different cause from the type 2 diabetes mostly seen in adults, which is often related to obesity and sedentary behaviour. Type 1 diabetes is an autoimmune disorder in which the body attacks cells in the pancreas that make insulin.

Nobody knows what sends the body’s own immune system attacking pancreatic cells, said Dr Erin Kershaw, Chief of Endocrinology, University of Pittsburgh Medical Center in Pennsylvania, who wasn’t involved in the study.

Sattar and his colleagues studied 27,195 individuals aged 18 years and older in the Swedish National Diabetes Register who had been diagnosed with type 1 diabetes and compared them with 135,178 age-matched people in the general population who did not have diabetes.

The researchers followed the group through medical records, with half of the subjects followed for at least 10 years, during which time 959 of those with diabetes and 1,501 people without diabetes  died.

People who developed type 1 diabetes before the age of 10 were more than four times as likely as their counterparts in the general population without diabetes to die of any cause during the follow-up period, and four times as likely to die of cardiovascular disease.

Those with diabetes diagnosed before age 10 were also about 30 times as likely as counterparts without diabetes to develop heart disease and 31 times as likely to experience a heart attack, overall. Among just the women with early-onset diabetes, those rates were 60 times and 90 times, respectively.

In contrast, people who developed type 1 diabetes between the ages of 26 and 30, were about three times as likely as the general population to die during the follow-up, and about six times as likely to develop heart disease or experience a heart attack.

The drop in risk with later-onset diabetes relative to non-diabetics also means that people with the youngest-onset disease were six times as likely overall as those who developed type 1 diabetes at an older age to have a heart attack, for example.

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