{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:15:01Z","timestamp":1780445701090,"version":"3.54.1"},"reference-count":35,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T00:00:00Z","timestamp":1658275200000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003092","name":"Diabetes Fonds","doi-asserted-by":"publisher","award":["2015.16.1856"],"award-info":[{"award-number":["2015.16.1856"]}],"id":[{"id":"10.13039\/501100003092","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"accepted":{"date-parts":[[2022,7,7]]},"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Cardiovascular disease (CVD) is the leading cause of mortality in individuals with type 1 diabetes mellitus (T1DM). Cardiovascular risk management is therefore essential in the management of individuals with T1DM. This study describes the performance of lipid and blood pressure management in individuals with T1DM using three guidelines.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research design and methods<\/jats:title>\n                  <jats:p>Individuals \u226518 years with T1DM, treated with insulin for \u22651 year, visiting Diabeter or the University Medical Center Groningen between January 1, 2018 and December 31, 2018, were included. Lipid and blood pressure management were examined using the Dutch, American Diabetes Association (ADA) and National Institute for Health and Care Excellence (NICE) guidelines. Concordance of recommended and prescribed lipid-lowering (LLM) or antihypertensive medication (AHM) was assessed per guideline and 10-year age groups. Achievement of treatment targets was assessed for those prescribed medication.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 1855 individuals with T1DM were included. LLM and AHM was prescribed in 19% and 17%, respectively. In individuals recommended LLM, this was prescribed in 22%\u201346% according to Dutch, ADA or NICE guideline recommendations. For individuals recommended AHM, this was prescribed in 52%\u201375%. Recommended and actual prescription of LLM and AHM increased over age for all three guidelines. However, discordance between treatment recommendation and medication prescribed was higher in younger, compared with older, age groups. Low-density lipoprotein-cholesterol targets were achieved by 50% (without CVD) and 31% (with CVD) of those prescribed LLM. The blood pressure target was achieved by 46% of those prescribed AHM.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study suggests that there is undertreatment of lipid and blood pressure according to guideline recommendations, particularly in younger age groups. Treatment targets are not met by most individuals prescribed medication, while guidelines recommendations differ considerably. We recommend to investigate the factors influencing undertreatment of lipid and blood pressure management in individuals with T1DM.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjdrc-2022-002765","type":"journal-article","created":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T11:11:52Z","timestamp":1658315512000},"page":"e002765","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Cardiovascular risk management in people with type 1 diabetes: performance using three guidelines"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5656-6244","authenticated-orcid":false,"given":"Rita Delphine Maiko","family":"Varkevisser","sequence":"first","affiliation":[{"name":"Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwin","family":"Birnie","sequence":"additional","affiliation":[{"name":"Diabeter, Center for Focussed Diabetes Care and Research, Rotterdam, The Netherlands"},{"name":"Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0908-6560","authenticated-orcid":false,"given":"Charlotte E","family":"Vollenbrock","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dick","family":"Mul","sequence":"additional","affiliation":[{"name":"Diabeter, Center for Focussed Diabetes Care and Research, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9702-6551","authenticated-orcid":false,"given":"Peter R","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie M","family":"van der Klauw","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henk","family":"Veeze","sequence":"additional","affiliation":[{"name":"Diabeter, Center for Focussed Diabetes Care and Research, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9262-6921","authenticated-orcid":false,"given":"Bruce H R","family":"Wolffenbuttel","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henk-Jan","family":"Aanstoot","sequence":"additional","affiliation":[{"name":"Diabeter, Center for Focussed Diabetes Care and Research, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,7,20]]},"reference":[{"key":"2025073111393782000_10.4.e002765.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052187"},{"key":"2025073111393782000_10.4.e002765.2","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1056\/NEJMoa1608664","article-title":"Mortality and cardiovascular disease in type 1 and type 2 diabetes","volume":"376","author":"Rawshani","year":"2017","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025073111393782000_10.4.e002765.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1408214"},{"key":"2025073111393782000_10.4.e002765.4","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-S011"},{"key":"2025073111393782000_10.4.e002765.5","unstructured":"Dutch College of General Practitioners,, Dutch Internists Association,, Dutch Society for Cardiology . 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