No change has been seen in the last three decades in the occurrence of some serious complications of type 1 diabetes, such as heart disease and retina damage, new research from a US-based study suggests.

“Doctors have long considered type 1 diabetes a small blood vessel problem, so they have traditionally not focused on the potential large blood vessel complications, such as cardiovascular disease,” lead author Georgia Pambianco, said in a statement. “However, our study suggests that doctors and their patients need to pay more attention to factors that affect the larger blood vessels, such as lipids and blood pressure.”

The findings are based on an analysis of data from 901 participants in the Pittsburgh Epidemiology of Childhood-Onset Diabetes Complications Study, which included data from patients diagnosed with type 1 diabetes between 1950 and 1980.

As reported in the medical journal Diabetes, rates of premature death, kidney failure, and nerve damage did fall significantly during the study period. In fact, patients who were diagnosed with diabetes in the 1950s had a fivefold higher mortality rate than their peers who were diagnosed in the 1970s.

By contrast, no significant changes were noted in the occurrence of retinal damage and kidney impairment. Likewise, rates of coronary artery disease events - relatively infrequent complications compared with the others - also held steady during the study period.

Pambianco said that guidelines for managing type 1 diabetes are often derived from what is known about treating type 2 disease. However, the present findings reinforce the message that these are separate entities with their own unique complications, she added.

SOURCE: Diabetes, May 2006.