Treatment for Type I lowers heart disease

Intensive and early treatment of Type I diabetes substantially lowers the risk of cardiovascular ailments such as heart disease and stroke, shows a study from the University of Texas Southwestern Medical Center, Dallas. Patients who receive early and aggressive treatment for the disease, including the use of insulin pumps or multiple (three or more) daily insulin injections, glucose monitoring, and lifestyle intervention as young adults reduce their risk by almost 60%. Moreover, intensive glucose control prevents or delays eye, nerve, and kidney damage--common complications of Type I diabetes.

"We were one of the centers following about 60 patients and, when we started, most of our patients were, on average, 30 to 35 years old," explains Philip Raskin, professor of internal medicine. "We reported short-term health benefits from intensive treatment but, at that time, the patients weren't old enough to experience some of the cardiovascular disease and events that can afflict older patients with Type I diabetes. As that population has aged, the strategy of early intervention and aggressive control of the disease has shown tremendous health advantages."

Type I diabetes typically affects younger individuals and usually is diagnosed before age 40. Most patients are diagnosed by age 14. This kind of diabetes--which affects approximately 1,000,000 people in the U.S.--is associated with a lack of insulin. Pancreatic islet cells quit producing insulin in the quantities needed to maintain a normal blood glucose level, and patients must regiment their diets and take insulin daily to metabolize blood glucose.

Type I diabetes accounts for between five and 10% of all diabetes cases. The malady is the most common cause of blindness, kidney failure, and amputations in adults and a major cause of heart disease as well as stroke. "We don't know why it causes these complications. People who have it seem to have more problems with cardiovascular disease, particularly women," concludes Raskin.

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