Heart, Blood Pressure and Cholesterol

Heart disease and stroke are the largest long-term risks that come with diabetes of any type. In Type 1, diagnosed young, that feels a very long way off — which is exactly why the numbers get ignored for decades.

Good Type 1 care is not only about blood glucose. Blood pressure and cholesterol contribute to cardiovascular risk independently, so managing all three together is what actually reduces it.

The figures to know: blood pressure below 130/80 mmHg, checked at every visit. A lipid panel every five years under the age of 40, and yearly from 40. Statin treatment is recommended for many people with diabetes based on overall cardiovascular risk, and that is a conversation to have rather than a decision to defer.

Not smoking is the single largest item on the list, ahead of everything else here.

There is a South Asian dimension worth knowing. Indians develop diabetes and its cardiovascular consequences at lower body weight and waist size than white Europeans, which is why India uses lower thresholds — abdominal obesity from a waist of 90 cm in men and 80 cm in women.

So ask what your blood pressure and cholesterol targets are, and whether you are meeting them. Most people with Type 1 can recite their HbA1c and not those two.