Introduction and Objective: Patients with type 1 Diabetes (T1D) increasingly exhibit metabolic syndrome features, a phenotype termed “Double Diabetes.” We investigated the interaction of HbA1c and BMI with cardiovascular (CV) risk factors in a large cohort. Methods: This is a cross-sectional analysis of 1,266 persons living with T1D. CV risk was quantified by a composite score (hypertension, dyslipidemia, obesity, smoking, retinopathy, neuropathy, CKD). Poisson regression with interaction was used to test if overweight or obesity (OAO) modifies the impact of HbA1c on CV risk. Results: The mean age 24.3 ± 15.0 years, HbA1c was 9.32 ± 2.72%. There was a significant interaction between HbA1c and BMI (β=0.0046, p=0.002) Figure 1, in BMI of 20 kg/m² category, HbA1c was not significantly associated with CV risk. However, in BMI ≥30 kg/m², each 1% increase in HbA1c was associated with a 14% increase in the composite CV risk factors (p0.001). Multiple regression identified age (β=0.0286, p0.001) and male gender (β=0.23, p0.001) as independent predictors of higher CV risk. Conclusion: Our findings demonstrate that obesity may foster the vascular impact of hyperglycemia in T1D. This synergistic interaction suggests that glycemic control alone is not sufficient for optimum CV protection in T1D, therefore, proactive and sustained weight management should be an essential component of cardiometabolic risk reduction in T1D. Disclosure E. Abdelgadir: None. D. Osborne: None. J.M. Schattenberg: Consultant; Current; 89bio, Inc., Akero Therapeutics, Inc., Alentis Therapeutics, Alexion Pharmaceuticals, Inc., Altimmune, AstraZeneca, Bionorica, Boehringer Ingelheim International GmbH, Boston Therapeutics, Inc., Eli Lilly and Company, Gilead Sciences, Inc., GlaxoSmithKline plc., HistoIndex, Ipsen Biopharmaceuticals, Inc., Inventiva Pharma, Kriya Therapeutics, Madrigal Pharmaceuticals, Inc., Merck Sharp Current; AbbVie Inc., Boehringer Ingelheim International GmbH, Gilead Sciences, Inc., Ipsen Biopharmaceuticals, Inc., Lilly, Madrigal Pharmaceuticals, Inc., Novo Nordisk. Stock/Shareholder; Current; Hepta Bio. A.H. Khamis: None. K. Hafidh: None. J. Nafach: None. B.E. Mohamad: None.
ABDELGADIR et al. (Fri,) studied this question.