Evidence map›Paper›PMID 40364641›Full record

ArticleEuropean heart journal2025

Adult-onset type 1 diabetes: predictors of major cardiovascular events and mortality.

Yuxia Wei, Tomas Andersson, Tiinamaija Tuomi, Thomas Nyström, Sofia Carlsson

Abstract read
In one paragraph

Article in European heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed.

  1. Review
  2. Type 1 diabetes and cardiovascular medicine.Cardiovascular diabetology. Endocrinology reports · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Yuxia WeiInstitute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 17177 Stockholm, Sweden.ORCID 0000-0002-3390-0844
Tomas AnderssonInstitute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 17177 Stockholm, Sweden.ORCID 0000-0002-2185-0325
Tiinamaija TuomiDepartment of Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0002-8306-6202
Thomas NyströmDepartment of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-3462-7990
Sofia CarlssonInstitute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 17177 Stockholm, Sweden.ORCID 0000-0002-9497-2331

Funding

Research Council for Health, Working Life and Welfare 2018-00337the Academy of Finland 263401the Academy of Finland 267882the Academy of Finland 312063the Academy of Finland 312072the Academy of Finland 336822the Academy of Finland 336826the Folkhalsan Research Foundationthe SRP Diabetes Postdoctoral Fellowship Programme at Karolinska Institutetthe Swedish Diabetes Foundation DIA2022-735the Swedish Research Council 2018-03035the Swedish Research Council 2022-00811University of Helsinki
6 · The paper itself

Abstract

BACKGROUND AND

aimsThe prognosis of adult-onset type 1 diabetes (T1D) and prognostic factors are sparsely investigated. This study assessed mortality, major adverse cardiovascular events (MACE), and prognostic factors in adult-onset T1D, particularly focusing on those diagnosed at age ≥40.

methodsParticipants were people diagnosed with adult-onset T1D (n = 10 184) or type 2 diabetes (T2D, n = 375 523) in 2001-20 from the Swedish National Diabetes Register and 509 172 population controls from the Total Population Register, followed until 2022. Hazard ratios (HR) and population attributable risk fraction (PAR%) were estimated.

resultsPeople with T1D had higher incidence of MACE (HR 1.30 [95% confidence interval 1.17, 1.45]), all-cause mortality (1.71 [1.60, 1.84]), and mortality from cardiovascular or non-cardiovascular diseases, cancer, or infection than population controls. They had lower MACE incidence (0.67 [0.60, 0.75]) and higher mortality from diabetic coma or ketoacidosis (7.04 [4.54, 10.9]) than people with T2D. Smoking (PAR% 10.7%) and glycated haemoglobin (HbA1c) ≥ 53 mmol/mol (10.4%) accounted for most deaths while overweight/obesity (19.8%), smoking (8.4%), and high HbA1c (8.8%) accounted for most MACE events in T1D. Results were similar for T1D diagnosed at age ≥40, although they had lower insulin pump use and higher HbA1c than people diagnosed earlier.

conclusionsAdult-onset T1D carries excess risk of death and MACE compared with population controls but less MACE risk than T2D. Individuals diagnosed after age 40 had similar excess risk and poorer glycaemic control than those diagnosed earlier, underscoring the need for improved management. Key prognostic factors were smoking, poor glycaemic control, and overweight/obesity.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 1AdultAgedAge of OnsetDiabetes Mellitus, Type 2FemaleGlycated HemoglobinHumansIncidenceMaleMiddle AgedPrognosisRegistriesRisk FactorsSwedenGlycated HemoglobinAdult-onsetAll-cause mortalityCardiovascular diseasesCause-specific mortalityPrognostic factorsType 1 diabetes

Identifiers

PMID40364641
PMCPMC12500326

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.