Cardiometabolic & kidneyCohort study
Adult-onset type 1 diabetes: predictors of major cardiovascular events and mortality
- Registry-based cohort study
- nationwide registers
Authors' conclusion
Adult-onset T1D carries excess risk of death and MACE compared with population controls but less MACE risk than T2D. Individuals diagnosed after age 40 had similar excess risk and poorer glycaemic control than those diagnosed earlier
Study context
- Population
- People diagnosed with adult-onset T1D or T2D in 2001–20, Swedish National Diabetes Register, and population controls, followed until 2022
- Participants
- 10,184 / 375,523 / 509,172
- Exposure
- Adult-onset T1D vs population controls and vs T2D
- T1Dn = 10,184
- T2Dn = 375,523
- Population controlsn = 509,172reference
- Outcome
- Mortality, MACE and prognostic factors
Main finding
As reported in the abstract
MACE and all-cause mortality
Hazard ratio (95% CI)
T1D vs Population controlsMACE
1.30(1.17–1.45)
T1D vs Population controlsall-cause mortality
1.71(1.60–1.84)
T1D vs T2DMACE
0.67(0.60–0.75)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Mortality from diabetic coma or ketoacidosis | 7.04 (4.54–10.9) | |
| 0.050.21520Hazard ratio (log scale) |
Prognostic factors for death in T1D (PAR%)
- Smoking
- 10.7%
- HbA1c ≥ 53 mmol/mol
- 10.4%
Prognostic factors for major adverse cardiovascular events (MACE) in T1D (PAR%)
- Overweight/obesity
- 19.8%
- Smoking
- 8.4%
- High HbA1c
- 8.8%
T1D diagnosed at age ≥40 (subgroup)
- Results similar; lower insulin pump use and higher HbA1c than those diagnosed earlier
Original publication
Adult-onset type 1 diabetes: predictors of major cardiovascular events and mortality. Eur Heart J. Published 14 May 2025. doi:10.1093/eurheartj/ehaf304
Summarised from the published abstract; every number is checked against it