Demographic Predictors of Elevated LDL Cholesterol in Type 1 Diabetes: A Cross-Sectional Study

How effectively preventable cardiovascular disease risk factors such as elevated LDL cholesterol are being mitigated in a real-world U.S. type 1 diabetes population is not well understood, and the demographic factors that are independently associated with elevated LDL cholesterol in this population are not well defined. More than one-third of older adult patients with type 1 diabetes in this real-world database had elevated LDL cholesterol. Female sex, Medicaid insurance, and younger age were independently associated with elevated LDL cholesterol. Key Points · In this cross-sectional study of Premier Healthcare Database patients with type 1 diabetes aged 55–75 years (n = 4,987), 35% had elevated LDL cholesterol (≥100 mg/dL). · In patients also having a diagnosis code for cardiovascular disease (CVD) (n = 321), a majority (54%) had LDL cholesterol levels above target (≥70 mg/dL for this subpopulation). · Female sex (adjusted odds ratio [aOR] 1.61, 95% CI 1.43–1.81, P <0.001) and Medicaid insurance (aOR 1.92, 95% CI 1.30–2.84, P = 0.001) were independently associated with elevated LDL cholesterol. Older age (aOR per additional 5 years of age 0.92, 95% CI 0.86–0.98, P = 0.009) was independently associated with lower LDL cholesterol. · Elevated LDL cholesterol, a modifiable CVD risk factor, was inadequately addressed in this population with type 1 diabetes. Indeed, women and individuals with Medicaid insurance were particularly at risk for higher LDL cholesterol in this cohort.