Cardiovascular disease and beta-cell function at diagnosis of serologically defined adult-onset type 1 and type 2 diabetes in two Swedish cohorts 15 years apart
(2025) In BMJ Open 15(7). p.1-10- Abstract
OBJECTIVES: To describe the prevalence of cardiovascular disease (CVD) at the time of diagnosis of adult-onset type 1 (T1D) and type 2 (T2D) diabetes, in a recent cohort and compare to a previous cohort from the same region. Further, to explore factors influencing the prevalence of pre-existing CVD, including age, sex, body mass index (BMI) and C-peptide; in the later cohort also heart failure, hyperlipidaemia, tobacco use and physical activity.
DESIGN: Two prospective cross-sectional cohort studies compared.
SETTING: All primary health care centres and hospitals in Kalmar and Kronoberg counties in Southeastern Sweden.
PARTICIPANTS: Adults with newly diagnosed T1D or T2D (classified by combination of islet antibodies... (More)
OBJECTIVES: To describe the prevalence of cardiovascular disease (CVD) at the time of diagnosis of adult-onset type 1 (T1D) and type 2 (T2D) diabetes, in a recent cohort and compare to a previous cohort from the same region. Further, to explore factors influencing the prevalence of pre-existing CVD, including age, sex, body mass index (BMI) and C-peptide; in the later cohort also heart failure, hyperlipidaemia, tobacco use and physical activity.
DESIGN: Two prospective cross-sectional cohort studies compared.
SETTING: All primary health care centres and hospitals in Kalmar and Kronoberg counties in Southeastern Sweden.
PARTICIPANTS: Adults with newly diagnosed T1D or T2D (classified by combination of islet antibodies and C-peptide) in 1998-2001 and 2016-2017.
PRIMARY AND SECONDARY OUTCOME MEASURES: Prevalence of hypertension and CVD at diagnosis of diabetes, and associations with beta-cell function, in two cohorts collected 15 years apart. Further, to explore factors influencing the prevalence of hypertension and CVD, and level of C-peptide.
RESULTS: In patients with newly diagnosed T2D, mean age-at-onset had decreased (66±14.1 years vs 63±12.6, p≤0.001) and mean BMI had increased (29.0±5.4 vs 31.4±5.8 kg/m
2, p≤0.001). Prevalence of pre-existing myocardial infarction had decreased in both T1D (18% vs 7%, p=0.03) and T2D (25% vs 11%, p≤0.001). Pre-existing hypertension had increased in both T1D (23% vs 40%, p=0.01) and T2D (44% vs 61%, p≤0.001). C-peptide level was lower and was associated with several cardiovascular conditions in newly diagnosed T2D in 2016-2017 (p=0.048 p≤0.001).
CONCLUSIONS: Patients with newly diagnosed T2D were younger, with higher BMI, compared with 15 years earlier, a challenge for diabetes care. Prevalence of pre-existing myocardial infarction had decreased notably, in line with, but still less than in the general population; while pre-existing hypertension had increased, in both diabetes types. C-peptide was associated with several cardiovascular conditions in newly diagnosed T2D in the recent cohort, which warrants further investigation.
(Less)
- author
- organization
- publishing date
- 2025-07-16
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Humans, Sweden/epidemiology, Male, Female, Middle Aged, Cross-Sectional Studies, Diabetes Mellitus, Type 2/epidemiology, Cardiovascular Diseases/epidemiology, Insulin-Secreting Cells/physiology, Prospective Studies, Aged, Prevalence, Diabetes Mellitus, Type 1/epidemiology, Body Mass Index, C-Peptide/blood, Age of Onset, Hypertension/epidemiology, Adult, Risk Factors
- in
- BMJ Open
- volume
- 15
- issue
- 7
- article number
- e095630
- pages
- 1 - 10
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:40669900
- scopus:105011054044
- ISSN
- 2044-6055
- DOI
- 10.1136/bmjopen-2024-095630
- language
- English
- LU publication?
- yes
- additional info
- © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.
- id
- dea5b6a6-4f83-4130-b9db-841774b3f2d8
- date added to LUP
- 2025-10-10 12:20:22
- date last changed
- 2025-10-11 04:01:19
@article{dea5b6a6-4f83-4130-b9db-841774b3f2d8, abstract = {{<p>OBJECTIVES: To describe the prevalence of cardiovascular disease (CVD) at the time of diagnosis of adult-onset type 1 (T1D) and type 2 (T2D) diabetes, in a recent cohort and compare to a previous cohort from the same region. Further, to explore factors influencing the prevalence of pre-existing CVD, including age, sex, body mass index (BMI) and C-peptide; in the later cohort also heart failure, hyperlipidaemia, tobacco use and physical activity.</p><p>DESIGN: Two prospective cross-sectional cohort studies compared.</p><p>SETTING: All primary health care centres and hospitals in Kalmar and Kronoberg counties in Southeastern Sweden.</p><p>PARTICIPANTS: Adults with newly diagnosed T1D or T2D (classified by combination of islet antibodies and C-peptide) in 1998-2001 and 2016-2017.</p><p>PRIMARY AND SECONDARY OUTCOME MEASURES: Prevalence of hypertension and CVD at diagnosis of diabetes, and associations with beta-cell function, in two cohorts collected 15 years apart. Further, to explore factors influencing the prevalence of hypertension and CVD, and level of C-peptide.</p><p>RESULTS: In patients with newly diagnosed T2D, mean age-at-onset had decreased (66±14.1 years vs 63±12.6, p≤0.001) and mean BMI had increased (29.0±5.4 vs 31.4±5.8 kg/m<br> 2, p≤0.001). Prevalence of pre-existing myocardial infarction had decreased in both T1D (18% vs 7%, p=0.03) and T2D (25% vs 11%, p≤0.001). Pre-existing hypertension had increased in both T1D (23% vs 40%, p=0.01) and T2D (44% vs 61%, p≤0.001). C-peptide level was lower and was associated with several cardiovascular conditions in newly diagnosed T2D in 2016-2017 (p=0.048 p≤0.001).<br> </p><p>CONCLUSIONS: Patients with newly diagnosed T2D were younger, with higher BMI, compared with 15 years earlier, a challenge for diabetes care. Prevalence of pre-existing myocardial infarction had decreased notably, in line with, but still less than in the general population; while pre-existing hypertension had increased, in both diabetes types. C-peptide was associated with several cardiovascular conditions in newly diagnosed T2D in the recent cohort, which warrants further investigation.</p>}}, author = {{Ritsinger, Viveca and Gunnarsson, Rebecka and Melin, Eva and Hillman, Magnus and Stogianni, Anna and Holmberg, Sara and Johansson, Karin and Nilsson Neumark, Ann-Sofie and Krol, Herbert and Rööst, Mattias and Landin-Olsson, Mona and Neumark, Thomas and Wanby, Pär and Thunander, Maria}}, issn = {{2044-6055}}, keywords = {{Humans; Sweden/epidemiology; Male; Female; Middle Aged; Cross-Sectional Studies; Diabetes Mellitus, Type 2/epidemiology; Cardiovascular Diseases/epidemiology; Insulin-Secreting Cells/physiology; Prospective Studies; Aged; Prevalence; Diabetes Mellitus, Type 1/epidemiology; Body Mass Index; C-Peptide/blood; Age of Onset; Hypertension/epidemiology; Adult; Risk Factors}}, language = {{eng}}, month = {{07}}, number = {{7}}, pages = {{1--10}}, publisher = {{BMJ Publishing Group}}, series = {{BMJ Open}}, title = {{Cardiovascular disease and beta-cell function at diagnosis of serologically defined adult-onset type 1 and type 2 diabetes in two Swedish cohorts 15 years apart}}, url = {{http://dx.doi.org/10.1136/bmjopen-2024-095630}}, doi = {{10.1136/bmjopen-2024-095630}}, volume = {{15}}, year = {{2025}}, }