For women going through menopause, type 1 diabetes is associated with higher coronary artery calcium (CAC) volume and accelerated progression of CAC over time, according to a study published in the December issue of Diabetes Care.

Amena Keshawarz, from the University of Colorado School of Public Health in Aurora, and colleagues followed 311 premenopausal women with type 1 diabetes and 325 premenopausal women without diabetes enrolled in the Coronary Artery Calcification in Type 1 Diabetes study for more than 18 years. Computed tomography scans were used to measure CAC volume.

The researchers found that CAC volume was higher at baseline and increased more over time in women with type 1 diabetes versus women without diabetes. A significant diabetes-by-menopause interaction was seen, with postmenopausal women with type 1 diabetes having significantly higher CAC volumes than premenopausal women. There was no difference noted for women without diabetes. Even after adjusting for cardiovascular disease risk factors, the interaction remained significant.

"Given that type 1 diabetes incidence is increasing globally by 3 to 5 percent per year, and that improved treatment has increased longevity, a growing number of women with type 1 diabetes are living through menopause and into older age," the authors write. "It is imperative to examine how diabetes and sex-specific risk factors may interact to affect cardiovascular risk in this growing population, and how treatments could modify this risk."

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