It’s long been known that having type 1 diabetes increases the risk of heart disease in both women and men. But women with type 1 diabetes have a unique factor to contend with — menopause — that’s been shown to cause an additional increase in heart risk.
So it’s only logical to want to know how two established heart disease risk factors — having type 1 diabetes, and going through menopause — might interact with one another. A recent study, published in the journal Diabetes Care, was designed to do just that — and the results show just how important it is for women with type 1 diabetes, in particular, to pay attention to their heart health.
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In the study, researchers looked at coronary artery calcification — a risk factor for heart disease — in 311 women with type 1 diabetes and 325 women without it, before and after going through menopause. Participants attended up to four study appointments over 18 years in which they received computed tomography (CT) scans of their coronary arteries.
As might be expected, the volume of coronary artery calcification was greater in women with type 1 diabetes even at the beginning of the study. But the study’s key finding was that women with type 1 diabetes had significantly higher volumes of calcification after menopause than before, while in women without diabetes, menopause had no overall effect on calcification volume. This increased calcification in women with type 1 diabetes was still seen after the researchers adjusted for other known heart disease risk factors.
Due largely to differences in artery calcification, women with type 1 diabetes also saw an increase in a calculated score meant to predict overall heart disease risk, called an atherosclerotic CVD score. Before menopause, this number was 1.3% in women without diabetes and 1.5% in women with diabetes, while after menopause it was 1.7% in women without diabetes and 2.7% in those with type 1 diabetes.
The researchers noted that it’s unclear why menopause appears to increase artery calcification in women with type 1 diabetes, but not in other women — a topic that further studies might shed light on, potentially leading to treatment recommendations to address this risk. But in the meantime, this finding means that while screening for heart disease risk factors is important in all people with type 1 diabetes, it’s especially important in postmenopausal women.
A freelance health writer and editor based in Wisconsin, Phillips has a degree in government from Harvard University. He writes on a variety of topics, but is especially interested in the intersection of health and public policy.