{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T18:19:31Z","timestamp":1764785971737,"version":"3.46.0"},"reference-count":42,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"unspecified","delay-in-days":31,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013844","name":"University of Kentucky Center for Clinical and Translational Science","doi-asserted-by":"crossref","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100013844","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100006108","name":"NIH National Center for Advancing Translational Sciences","doi-asserted-by":"crossref","award":["UL1TR001998"],"award-info":[{"award-number":["UL1TR001998"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"accepted":{"date-parts":[[2025,11,6]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cardiovascular disease (CVD) is a common complication and major cause of mortality in people with type 1 diabetes (T1D). This study quantifies the prevalence of CVD among commercially insured adults with T1D in the USA from 2017 to 2021, overall and among age-defined and sex-defined subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research design and methods<\/jats:title>\n                    <jats:p>We used Merative MarketScan nationwide commercial insurance claims database (2017\u20132021) to identify adults \u226520 years with T1D (International Classification of Diseases, 10th Revision (ICD-10) codes). CVD ascertainment was based on ICD-10 codes for myocardial infarction, atrial fibrillation, ischemic heart disease, heart failure, peripheral artery disease, and stroke. Comorbidities included hypertension, obesity, hyperlipidemia, retinopathy, neuropathy, nephropathy, severe hypoglycemia, and diabetic ketoacidosis. Annual prevalence and age-specific and sex-specific prevalence of CVD were calculated overall and by comorbidities. Logistic regression was used to examine associations between sex, prevalent comorbidities, and odds of CVD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The sample size ranged from n=21\u2009748 in 2017 to n=13\u2009294 in 2021. Among adults with T1D (mean (SD) age (48.51 (13.95) years in 2017 and 46.80 (13.04) years in 2021; 47% female), the prevalence of CVD ranged from 18.18% (95% CI 17.77 to 18.66%) in 2017 to 20.58% (95% CI 19.91 to 21.24%) in 2021. In 2021, among those aged 20\u201339 years, 40\u201364 years, and 65+years, the prevalence of CVD was 4.97%, 20.41%, and 52.94%, respectively. The age-adjusted prevalence of CVD was higher in males than females (21.93% vs 19.07%). Age, sex, and all comorbidities were independently associated with CVD. Odds of CVD were highest among those with hypertension (adjusted OR 3.15, 95%\u2009CI: 2.77 to 3.57).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this sample of US commercially insured adults with T1D, CVD prevalence remained stable at ~20% from 2017 to 2021. Early detection via improved screening and targeted management of comorbidities are key preventive strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjdrc-2025-005121","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T18:15:30Z","timestamp":1764785730000},"page":"e005121","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Trends in cardiovascular disease prevalence among adults with type 1 diabetes in the USA: analysis of commercial claims data, 2017\u20132021"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8130-2200","authenticated-orcid":false,"given":"Orighomisan Freda","family":"Agboghoroma","sequence":"first","affiliation":[{"name":"College of Public Health, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kory R","family":"Heier","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omer","family":"Atac","sequence":"additional","affiliation":[{"name":"Department of Public Health, International School of Medicine, Istanbul Medipol University, Fatih, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meredith S","family":"Duncan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Kucharska-Newton","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8814-8725","authenticated-orcid":false,"given":"Mary E","family":"Lacy","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"2025120310152234000_13.6.e005121.1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6712a2"},{"key":"2025120310152234000_13.6.e005121.2","doi-asserted-by":"publisher","DOI":"10.2337\/db11-1625"},{"key":"2025120310152234000_13.6.e005121.3","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1007\/s41669-019-00192-9","article-title":"Burden of Cardiovascular Disease in Adult Patients with Type 1 Diabetes in the US","volume":"4","author":"Edelman","year":"2020","journal-title":"Pharmacoecon Open"},{"key":"2025120310152234000_13.6.e005121.4","doi-asserted-by":"crossref","unstructured":"Costacou T , Guo J , Miller RG , et al . 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