Prevalencia y control de los factores de riesgo cardiovascular en pacientes con diabetes mellitus tipo 1 candidatos a trasplante renopancreático entre los años 1999 y 2010

To study the evolution of the prevalence and control of the cardiovascular disease risk factors (CVDRFs) in a cohort of patients with type 1 diabetes (DM1) and end-stage renal disease (ESRD) candidates for kidney-pancreas transplant. Patients with DM1 and ESRD sent to our centre for evaluation of kidney-pancreas transplant between the years 1999-2010 were studied. They were divided into six biannual groups and the trend of CVDRFs control was evaluated (glycaemic control, lipids values, blood pressure and smoking habits). Poor control was considered if: HbA_1c greater than 7%, LDL greater than 100 mg/dL; blood pressure greater than 140/90 mmHg and current or ex-smokers. A total of 270 patients were included (62.9% male), with a mean age of 37.4 ± 14.9 years and a mean time since onset of diabetes of 24.7 ± 12.2 years. The mean HbA1c was 7.8 ± 6.83 and mean LDL was 105.06 ± 25.11 mg/dL. The percentage of patients with HbA1c < 7% increased from 23.5% in the first two-year period to 42.9% in 2009-2010 (=.009) and LDL < 100 mg/dL increased from 26,3% in 1999-2000 to 65,9% in 2009-2010 (<.005). The mean arterial systolic pressure was of 137.61 ± 21.53 and the diastolic pressure was 80.81 ± 22.02, with 54.6% of patients < 140/90, remaining stable throughout the period of observation. The percentage of patients who have never smoked was 47%, with no significant differences between the two year periods. Although the control of cardiovascular risk factors in patients with DMT1 and ESRD has improved over the last few years, it continues to be inadequate. An increased effort is required in order to optimise the management of this population group.