The major cause of morbidity and often premature mortality in people with type I diabetes
(T1D) is cardiovascular disease owing to accelerated atherosclerosis. We review publications
relating to the rationale behind, and clinical tests for, detecting and treating early
atherosclerosis in people with T1D. Currently available tools for atherosclerosis
assessment include risk equations using vascular risk factors, arterial intima-media
thickness, the ankle-brachial index, coronary artery calcification and angiography,
and for more advanced lesions, intravascular ultrasound and optical coherence tomography.
Evolving research tools include risk equations incorporating novel clinical, biochemical
and molecular tests; vascular MRI and molecular imaging. As yet there is little information
available to quantify early atherosclerosis. With better means to control the vascular
risk factors, such as hypertension, dyslipidaemia and glycaemic control, and emerging
therapies to control novel risk factors, further epidemiologic and clinical trials
are merited to facilitate the translation into clinical practice of robust means to
detect, monitor and treat early atherosclerosis in those with T1D. Cardiovasc Endocrinol
Metab 8: 14-27 Copyright (c) 2019 Wolters Kluwer Health, Inc. All rights reserved.