Treatment goal achievement and association with 10-year and 30-year atherosclerotic cardiovascular disease risks in patients with type 1 diabetes mellitus in Taiwan: The Taiwan Diabetes Registry

Abstract

Abstract Background. Guidelines for diabetes care recommend specific treatment goals for blood glucose, blood pressure and lipid control to prevent long-term complications of diabetes. However, there are few reports on the achievement of goals and its association with cardiovascular risks in patients with type 1 diabetes mellitus (T1D). Methods. We analyzed data for patients with T1D from the Taiwan Diabetes Registry to examine the status of goal attainments and 10- and 30-year risk estimates for atherosclerotic cardiovascular disease (ASCVD). Univariable and multivariable linear regression were performed to evaluate factors associated with ASCVD risk estimates. Treatment goals were defined as A1C < 7.0%, blood pressure < 130/80 mmHg, and LDL cholesterol < 100 mg/dl or total cholesterol < 160 mg/dl. Results. The percentage of subjects fulfilling all targets was 9.9%. Meeting more treatment goals was associated with decreased ASCVD risk estimates (geometric means [95% confidence interval (CI)] of 10-year risk estimate with none to all three goal attainments: 4.6% [3.2-6.5], 3.4% [2.7-4.2], 2.1% [1.7-2.6], and 1.7% [1.1-2.6]). Association was found between waist circumference and higher 10-year ASCVD risk in the multivariable regression analysis (β-coefficient 0.24, 95% CI 0.09-0.40; P=0.002). Conclusions. Attainment of two or more treatment goals is associated with lower short- and longer-term risk estimates for ASCVD in patients with T1D.