{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:39:27Z","timestamp":1790602767628,"version":"4.1.0"},"reference-count":39,"publisher":"American Diabetes Association","issue":"12","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC3500101"],"award-info":[{"award-number":["2022YFC3500101"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>The association of insulin resistance (IR) with cardiovascular disease (CVD) and all-cause mortality in type 1 diabetes (T1D) remains unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PURPOSE<\/jats:title>\n                  <jats:p>To investigate whether IR is associated with CVD and all-cause mortality among individuals with T1D.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>DATA SOURCES<\/jats:title>\n                  <jats:p>PubMed, Embase, and the Cochrane Library databases were searched from inception to 31 October 2023.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>STUDY SELECTION<\/jats:title>\n                  <jats:p>Observational studies reporting the associations between IR, as calculated by the estimated glucose disposal rate (eGDR), and the risk of CVD and all-cause mortality in individuals with T1D were eligible for inclusion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>DATA EXTRACTION<\/jats:title>\n                  <jats:p>Data from eight selected studies were extracted, pooled by random-effects models, and results are presented as hazard ratios (95% CIs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>DATA SYNTHESIS<\/jats:title>\n                  <jats:p>Eight studies involving 21,930 individuals were included, of which five studies involving 19,960 individuals with T1D reported the risk of CVD. During a median follow-up of 10 years, there were 2,149 cases of incident CVD. The pooled hazard ratio for composite CVD outcome per 1-unit increase in the eGDR index was 0.83 (95% CI 0.78\u20130.90, I2 = 58.9%). Five studies involving 19,403 individuals reported the risk of all-cause mortality. During a median follow-up of 10 years, 1,279 deaths were observed. The pooled hazard ratio for all-cause mortality per 1-unit increase in the eGDR index was 0.84 (95% CI 0.81\u20130.87, I2 = 0%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>LIMITATIONS<\/jats:title>\n                  <jats:p>The small number of available studies restricted our ability to perform meta-regression analyses or more detailed subgroup analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>IR, as calculated by the eGDR, may be an additional risk factor for CVD and all-cause mortality in T1D.<\/jats:p>\n               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