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JOHN PETRIE: I'm John Petrie.
I'm professor of diabetic
medicine at the University
of Glasgow in the UK.
This presentation is
about Type 1 Diabetes,
Control and Complications Trials.
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The complications of diabetes
that have been established
over many years are shown on the
left-hand side of this slide,
and the more recently recognized
ones are on the right.
The complications that we
will be focusing on today
are those of myocardial
infarction and stroke,
sometimes known as the
macrovascular complications,
which can also include
peripheral vascular disease.
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The slide here shows a study by
Krolewski, which compared the rates
of mortality in the Pittsburgh
cohort of people with type 1
diabetes, with those in
the Framingham cohort,
looking at mortality over
different age groups.
And from this slide,
published in 1987,
you can see that the rates of
mortality in people with type 1
diabetes were very high.
And this was mainly due to coronary
artery disease in comparison
with non-diabetic,
healthy individuals
in the Framingham cohort.
This is a case in men and women.
And the relative risk of
mortality at any particular age,
you'll see in this slide, is
really massively elevated up
to 20-fold in some age groups, and
particularly high in young women
in whom the background
rates in the population
are, of course, very low.
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We have updated in the
next slide these data
in the Scottish population in
which we have about 25,000 people
with type 1 diabetes who
were followed up using
our nationwide unintrusive
epidemiology systems with data
linkage not just to mortality
data, but to morbidity data
and also pharmacy data
and biochemistry data.
This particular slide is a
publication from a few years ago,
PLOS Medicine, where we've looked
in a very similar manner to the risk
of cardiovascular disease
and total mortality in adults
with type 1 diabetes in Scotland.
This shows the
age-standardized rate of events
according to different age
groups in males and females
with and without type 1 diabetes.
You can see that if you
compare the red line at the top
with the blue line
two from the bottom,
this are the rates of events in men
with and without type 1 diabetes
and really summarizing the
relative risk in terms of incidence
rates of cardiovascular disease.
The men right across
the spectrum, the rates
are elevated to almost
two-and-a-half-fold
and in women threefold.
And the risk starts at
a very young age group.
