The Steno T1 Risk Engine

Developing a screening method for cardiovascular disease in people with type 1 diabetes

Aim and purpose

Despite significant improvements in the treatment and detection of complications, patients with type 1 diabetes still have an increased mortality compared with the general population. Cardiovascular disease is the main cause of death, but there is no established method for screening for cardiovascular disease in type 1 diabetes.

Our aim is to develop a risk calculator (engine) in patients with type 1 diabetes for predicting their five- and 10-year risk of non-fatal and fatal cardiovascular disease (Ischemic heart disease, Stroke, Peripheral vascular disease).

Design and method
This study is based on detailed clinical data from the electronic health record of the approximately 5,000 patients with type 1 diabetes treated at Steno Diabetes Center. The clinical has been linked with the following Danish registers:

  • National Patient Register (non-fatal cardiovascular disease events)
  • Cause of Death Register (fatal cardiovascular disease events)
A combination of established and novel statistical methods has been used develop the risk engine. These include Poisson regression analysis, random forest analyses and decision tree analysis.

The risk engine has been validated on the type 1 diabetes population in the Funen (regional) Diabetes Database in Denmark.

Target group

The project targets patients with type 1 diabetes and their healthcare provider/doctor.

Expected outcome
Expected ending is first quarter of 2016.

We expect to develop a risk engine estimating five- and 10-year risk of non-fatal and fatal cardiovascular disease in patients with type 1 diabetes patients.

Subsequently, the goal is to develop an online tool free for clinicians working with type 1 diabetes. The online tool will give an individual risk profile of a patient based on his/her clinical data. In this way, the tool will support the progress towards more personalised care (individual treatment strategies) in the clinic.

Sidst opdateret 18-08-2016


Dorte Vistisen 
Senior researcher