A balancing act: Navigating cardiovascular vigilance and hypoglycaemia awareness in type 1 diabetes

This thesis explores two main areas in type 1 diabetes: cardiovascular risk management (CVRM) and the condition of impaired awareness of hypoglycaemia (IAH).

In Part 1, the research examines the differences in cardiovascular health between people with and without type 1 diabetes. The findings show that while people with type 1 diabetes tend to have lower LDL cholesterol, they often have higher blood pressure. It also highlights that many patients, especially younger individuals, are not receiving optimal treatment to lower their risk of heart disease. Moreover, cardiovascular risks are better managed in men with type 1 diabetes than women.

Part 2 investigates IAH, a condition where people with type 1 diabetes no longer feel the warning signs of low blood sugar, which can lead to severe hypoglycaemia. The research identified potential biological markers and factors linked to IAH, such as certain AgRP and lipid metabolites. It also showed that lower C-peptide levels was associated with an increased risk of developing IAH, while weight gain was associated with reversal of IAH.

Overall, this thesis emphasizes the need for improved cardiovascular treatment in type 1 diabetes and provides new insights into the causes and potential treatments for IAH.