We’ve long understood that conditions like obesity, chronic kidney disease, and coronary artery disease are closely connected – but new research highlights just how important where fat is distributed may be, especially for individuals with type 1 diabetes.
A large, long-term study from the Finnish Diabetic Nephropathy Study followed over 4,300 adults with type 1 diabetes who had no prior history of heart disease. Researchers focused on central obesity, measured using the waist-to-height ratio (WHtR), a simple but powerful marker of abdominal fat.
Key Findings
- 15.3% of participants experienced a CAD-related event (heart attack, revascularization, or death)
- Those with central obesity had more than double the risk:
- 10-year risk: 11.6% vs. 4.4%
- 20-year risk: 25.3% vs. 9.9%
Each 0.1 increase in WHtR was associated with a 21% higher risk of CAD overall, even after adjusting for other risk factors.
Interestingly, the association was even stronger in individuals without albuminuria (a marker of kidney damage), suggesting that central obesity may independently drive cardiovascular risk – even before kidney complications appear.
This is News
While albuminuria has traditionally been used to identify higher cardiovascular risk in diabetes, this study suggests that abdominal fat distribution may be an early and underrecognized warning sign.
In other words:
- You don’t need existing kidney disease to be at increased heart risk
- Central obesity alone is a significant predictor of future heart disease
Meaning…
For patients with type 1 diabetes, measuring the waist-to-height ratio (keep it below 0.5) may be a simple, effective way to:
- Identify elevated cardiovascular risk earlier
- Guide lifestyle interventions
- Support more personalized risk assessment beyond traditional markers
Bye Belly – Hello Health
Central obesity isn’t just a cosmetic concern—it’s a powerful, independent risk factor for heart disease in type 1 diabetes. Addressing abdominal fat through targeted lifestyle strategies could play a key role in preventing future cardiovascular events—even in otherwise “low-risk” patients.
Erika Bezerra ParenteFanny Jansson SigfridsPer-Henrik GroopLena M. ThornNiina SandholmValma HarjutsaloFinnDiane Study Group*; Waist-to-Height Ratio Is Associated With the Risk of Coronary Artery Disease in Type 1 Diabetes: A 19-Year Cohort Study. Diabetes Care 2026; dc252811. https://doi.org/10.2337/dc25-2811
