Quick, non-invasive heart scan may be a lifesaver for type 1 diabetics, report University Of Pittsburgh researchers

August 22, 2000

PITTSBURGH, Aug. 23 -- People with Type 1 diabetes develop heart disease at more than five times the rate of the general population, making it the leading cause of death among these patients. Researchers at the University of Pittsburgh Graduate School of Public Health (GSPH) and the University of Pittsburgh Medical Center (UPMC) Cardiovascular Institute have found that a fast, non-invasive heart scan using electron beam computed tomography (EBT) may be an important tool in identifying Type 1 diabetic patients who are at a particularly high risk for heart disease. Their findings were published in the September issue of Diabetes, a journal of the American Diabetes Association.

"Finding a way to identify high-risk subjects early is critical in preventing the high mortality and suffering that many Type 1 diabetic patients endure from heart disease," said Trevor Orchard, M.D., professor of epidemiology at GSPH and the study's principal investigator.

EBT is a quick, simple scan used to identify and measure calcium build-up in the arteries leading to the heart. This build-up is seen in individuals with developing blockages in the coronary arteries, some of which may eventually lead to angina and heart attack.

The University of Pittsburgh study is the first to report the use of EBT to identify people with Type 1 diabetes at high risk for heart disease. Risk is normally measured using well-known risk factors such as blood pressure and cholesterol readings, and information on health behaviors like smoking.

"EBT provides an excellent measure of atherosclerotic burden in the coronary arteries," said Daniel Edmundowicz, M.D., assistant professor of medicine, director of the Preventive Heart Care Center at the UPMC Cardiovascular Institute and study co-investigator. "We believe the test will identify some diabetics as higher risk than might be thought based on traditional risk factors. If so, they could be identified much earlier in their coronary artery disease process, giving us more time to lower their risk with medications and lifestyle changes, and possibly other interventions."

Type 1 diabetes, sometimes called "juvenile diabetes," typically strikes in childhood when the pancreas cannot make insulin, a hormone that helps glucose enter cells so that it can be used for energy. Type 1 diabetic patients must take regular insulin injections.

The current analysis used data from the Pittsburgh Epidemiology of Diabetes Complications Study, an ongoing 10-year prospective study of risk factors for complications of Type 1 diabetes. More than 300 participants, all diagnosed as children, had the EBT, and their resulting calcium scores were compared with other risk factors and their history of heart disease.

"Because patients with Type 1 diabetes might develop extra calcium in their arteries that is not related to atherosclerosis, we were uncertain how well the test would identify subclinical heart disease in these patients," said lead author Jon Olson, Ph.D., of the GSPH. "However, we found a strong association between high calcium scores and heart disease, and also between high calcium scores and the standard risk factors. These relationships suggest that the high scores do indeed indicate atherosclerosis."

Investigators consider the collection of these data to be the first step in evaluating the EBT's usefulness in identifying those patients who are at highest risk. They will continue monitoring the study participants for further signs of heart disease to determine if the EBT predicts better than the standard risk factors.

"It is too soon to suggest that all Type 1 diabetic patients have an EBT, which in any case is not widely available," said Dr. Orchard. "However, it remains extremely important that diabetic patients keep in close touch with their physicians and carefully monitor their blood pressure and lipids. These factors must be strictly controlled."
-end-
This study was supported by the National Institutes of Health.

ta/08-15-00

Contact fax: 412-624-3184


University of Pittsburgh Medical Center

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.