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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

Ritsinger, Viveca ; Gunnarsson, Rebecka ; Melin, Eva LU ; Hillman, Magnus LU orcid ; Stogianni, Anna LU ; Holmberg, Sara ; Johansson, Karin ; Nilsson Neumark, Ann-Sofie ; Krol, Herbert and Rööst, Mattias LU , et al. (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.

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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}},
}