4.3.0.0 A1C and Car­dio­vas­cu­lar Dis­ease Out­comes

4.3.1.0 Car­dio­vas­cu­lar Dis­ease and Type 1 Di­a­betes

CVD is a more com­mon cause of death than mi­crovas­cu­lar com­pli­ca­tions in pop­u­la­tions with di­a­betes. There is ev­i­dence for a car­dio­vas­cu­lar benefit of in­ten­sive glycemic con­trol after long-‍term fol­low-‍up of co­horts treat­ed early in the course of type 1 di­a­betes. In the DCCT, there was a trend to­ward lower risk of CVD events with in­ten­sive con­trol. In the 9-year post-‍DCCT fol­low-‍up of the EDIC co­hort, par­tic­i­pants pre­vi­ous­ly ran­dom­ized to the in­ten­sive arm had a significant 57% re­duc­tion in the risk of non­fa­tal my­ocar­dial in­farc­tion (MI), stroke, or car­dio­vas­cu­lar death com­pared with those pre­vi­ous­ly ran­dom­ized to the stan­dard arm (28). The benefit of in­ten­sive glycemic con­trol in this co­hort with type 1 di­a­betes has been shown to per­sist for sev­er­al decades (29) and to be as­so­ci­at­ed with a mod­est re­duc­tion in all-‍cause mor­tal­i­ty (30).