New research has shown there has been a shift in the risk of arterial disease for people with type 1 and type 2 diabetes.

While there has been a significant reduction in the risk of stroke and heart attack, what is being seen now are complications in peripheral vessels.

Those behind the research from the University of Gothenburg have said their findings show “potential” for greater risk reduction by targeting modifiable factors, including early and intensive control of long-term blood sugar.

The team examined 20 years of long-term disease trends for almost all peripheral arterial diseases, looking in particular at modifiable risk factors, optimal levels for cardiometabolic risk factors, and how important of certain risk factors are.

Researchers looked at data from more than 34,200 people with type 1 diabetes and more than 655,200 people with type 2 diabetes from the Swedish National Diabetes Register, from the period 2001 to 2020. Data from just over 2.6m people without diabetes was also included.

The researchers found that generally, there has been a shift away from risk from arterial diseases in the central organs – including heart attack and stroke – to complications in peripheral vessels.

Long term blood sugar was found to be the most significant marker for peripheral arterial disease in both type 1 and type 2 diabetes.

The research team say that for people with type 1 diabetes, keeping a closer eye on long-term blood sugar and blood pressure could reduce the risk of a number of peripheral arterial complications by 30% to 50%.

Researcher Aidin Rawshani, a resident physician in cardiology and internal medicine at Sahlgrenska University Hospital Östra, said: “Our results reveal the potential for an even greater risk reduction for future events by maintaining lower levels of cardiometabolic risk factors, particularly early and intensive control of long-term blood sugar.

“We also noted that the relative importance of these risk factors differs between the central and peripheral arteries, revealing differences in biological effects that cardiometabolic risk factors exert in different parts of the arterial tree.

“Long-term blood sugar plays a much more significant role in the development of peripheral arterial disease.”

The two research studies can be found here and here.

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