Title:Arterial Stiffness and Type 1 Diabetes: The Current State of Knowledge
Volume: 18
Issue: 3
Author(s): Michal Kulecki*, Aleksandra Uruska, Dariusz Naskret and Dorota Zozulinska-Ziolkiewicz
Affiliation:
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznań, Poland
Keywords:
Arterial stiffness, type 1 diabetes, pulse wave velocity, diabetic complications, cardiovascular diseases, cardiovascular risk.
Abstract: The most common cause of mortality among people with type 1 diabetes is cardiovascular
diseases. Arterial stiffness allows predicting cardiovascular complications, cardiovascular mortality,
and all-cause mortality. There are different ways to measure arterial stiffness; the gold standard
is pulse wave velocity. Arterial stiffness is increased in people with type 1 diabetes compared
to healthy controls. It increases with age and duration of type 1 diabetes. Arterial stiffness among
people with type 1 diabetes positively correlates with systolic blood pressure, obesity, glycated hemoglobin,
waist circumference, and waist to hip ratio. It has a negative correlation with the estimated
glomerular filtration rate, high-density lipoprotein, and the absence of carotid plaques. The increased
arterial stiffness could result from insulin resistance, collagen increase due to inadequate
enzymatic glycation, and endothelial and autonomic dysfunction. The insulin-induced decrease in
arterial stiffness is impaired in type 1 diabetes. There are not enough proofs to use pharmacotherapy
in the prevention of arterial stiffness, but some of the medicaments got promising results in single
studies, for example, renin-angiotensin-aldosterone system inhibitors, statins, and SGLT2 inhibitors.
The main strategy of prevention of arterial stiffness progression remains glycemic control
and a healthy lifestyle.
