Diabetol Metab Syndr. 2026 Jul 13. doi: 10.1186/s13098-026-02216-x. Online ahead of print.
ABSTRACT
BACKGROUND: Cardiovascular diseases (CVDs) remain a major complication of type 1 diabetes mellitus (T1DM). Although healthy lifestyle behaviors are associated with lower cardiovascular risk in the general population and in individuals with type 2 diabetes mellitus, evidence specific to T1DM is limited. This study aimed to examine the associations of individual and composite healthy lifestyle factors with incident CVDs among individuals with T1DM.
METHODS: This prospective cohort study included participants with T1DM from the UK Biobank who were free of CVDs at baseline. A composite lifestyle score was constructed from six factors: smoking status, alcohol consumption, body mass index (BMI), diet quality, physical activity, and sleep duration. The primary outcomes were incident CVDs, including coronary heart disease (CHD), heart failure (HF), and stroke. Associations were assessed using Cox proportional hazards models, with subgroup analyses stratified by key demographic and clinical characteristics.
RESULTS: Over a median follow-up of 14.38 years, 455 incident CVD events were documented among 1,390 participants with T1DM. Maintaining a BMI of 25 to < 30 kg/m2 (HR, 0.65; 95% CI, 0.52-0.81) or 18.5 to < 25 kg/m2 (0.59; 0.45-0.78), adhering to a healthy diet (0.83; 0.69-0.99), and obtaining adequate sleep duration (0.77; 0.63-0.92) were independently associated with a reduced risk of CVDs. Compared with participants with a lifestyle score of 0-2, those with a score 4-6 had a significantly lower risk of composite CVDs (0.58; 0.46-0.73), CHD (0.63; 0.49-0.81), and HF (0.49; 0.34-0.70). These associations were generally consistent across subgroups.
CONCLUSIONS: Among individuals with T1DM, healthy lifestyle profiles were associated with a lower risk of incident CVDs, particularly through weight management, healthy diet, and adequate sleep duration. These findings support the potential value of incorporating lifestyle assessment and promotion into cardiovascular risk management for individuals with T1DM.
PMID:42443959 | DOI:10.1186/s13098-026-02216-x