What New Research Reveals About Heart Disease Risk in Type 1 Diabetes

People with Type 1 diabetes face a significantly higher risk of heart disease and stroke compared to the general population. Yet predicting *who* will experience these events—and *when*—remains challenging. A new study published in *Cardiovascular Diabetology* offers clues by examining a simple, painless imaging test: carotid ultrasound.

The carotid arteries are major blood vessels in the neck that supply blood to the brain. When plaques (fatty deposits) build up in these vessels, it signals atherosclerosis—the progressive narrowing and hardening of arteries. Researchers wanted to know whether visible plaque in the carotid arteries could predict future heart attacks, strokes, and other serious cardiovascular events in people with Type 1 diabetes.

The research team followed 701 adults with Type 1 diabetes for an average of nearly 6 years. Participants were at least 40 years old or had lived with diabetes for at least 10 years along with another cardiovascular risk factor. All received a carotid ultrasound as part of a cardiovascular risk assessment program.

Over the follow-up period, 45 participants experienced a major cardiovascular event—including 18 heart attacks, 14 cases of peripheral artery disease (blockages in leg arteries), 6 strokes, 3 cases of heart failure, and 4 deaths from cardiovascular causes. An additional 5 deaths occurred from non-cardiovascular causes.

The results were striking: participants with carotid plaques had roughly three times the risk of experiencing one of these events compared to those without visible plaque. The more plaques present, the greater the risk—people with three or more plaques faced even higher odds of future cardiovascular problems.

In this cohort, carotid plaques were present in 40% of participants—a substantial proportion. When researchers looked at risk levels, they found that the presence of plaque remained a strong predictor of future cardiovascular events even after accounting for age, sex, blood sugar control, blood pressure, cholesterol, and kidney disease.

Specifically, people with a high burden of plaque (three or more) maintained roughly a threefold increased risk of cardiovascular events. This suggests that not only the presence of plaques but also their number matters when assessing risk.

These findings suggest that a carotid ultrasound—a non-invasive imaging test—may help identify people with Type 1 diabetes who are at higher risk for heart disease and stroke. This could allow doctors to offer earlier, more intensive monitoring or preventive strategies to those who might benefit most.

However, this study is observational, meaning it shows an association between carotid plaques and cardiovascular events but does not prove that plaques directly cause these events. More research is needed to determine whether screening all people with Type 1 diabetes with carotid ultrasound would change outcomes, or which individuals would benefit most from this test.

If you have Type 1 diabetes and concerns about your cardiovascular health, talk with your healthcare team about your individual risk factors and what monitoring or prevention strategies may be right for you.

Source: Cardiovascular diabetology. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.