Cardiovascular Disease among commercially insured adults with type 1 diabetes in the US , 2016-2019

Abstract

Objectives: The objective of this study is to examine the overall as well as age- and sex-specific burden of cardiovascular disease (CVD) among adults with type 1 diabetes (T1D) in the US using nationwide commercial claims data from 2016-2019. Research Design and Methods We used nationwide commercial claims data (1/1/2016-12/31/2019) from Merative™MarketScan to identify adults ≥20 years with T1D (ascertained using ICD-10 codes). CVD was ascertained using ICD-10 diagnostic codes for myocardial infarction, atrial fibrillation, ischemic heart disease, heart failure, peripheral arterial disease, and stroke. The annual prevalence and age-specific prevalence of CVD were calculated. Age-adjusted prevalence of CVD by sex and select comorbidities was also calculated and multivariable logistic regression analysis was used to determine associations between sex, prevalent comorbidities, and CVD. Results: The number of people with T1D ranged from 39,134 to 52,133 across the study years (age of 47 (14-16) years; 48% female) and the prevalence of CVD ranged from 15.63% in 2016 to 16.68% in 2019. In 2019, among those aged 20-39 years, 40-64 years, and 65 years and older, the prevalence of CVD was 3.40%, 18.01 %, and 53.62%, respectively. A higher proportion of males had CVD compared to females (18.8% vs. 16.06%). The prevalence of CVD was high in the presence of all comorbidities; the odds of CVD among those with hypertension was 2.58(95%CI-2.39-2.79, nephropathy 2.02(95% CI 1.88-2.18), and neuropathy 2.16(95%CI-2.02-2.31). Conclusion: One-sixth of adults with T1D have CVD; the prevalence of CVD is higher in older age groups, males, and people with comorbidities. This study highlights the need for early screening for, and diagnosis of CVD and comorbidities associated with CVD in this population