Bebu I, Schade D, Braffett B, et al. - Given that the Diabetes Control and Complications Trial (DCCT) and its observational follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) showed the dominant role of glycemia, second only to age, as a risk factor for a first cardiovascular event in T1D, researchers explored the connection between established risk factors and the total cardiovascular disease (CVD) burden, including subsequent (ie, recurrent) events. In the 1,441 DCCT/EDIC candidates, CVD events were analyzed separately by type (CVD death, acute myocardial infarction [MI], stroke, silent MI, angina, percutaneous transluminal coronary angioplasty/coronary artery bypass graft [PTCA/CABG], and congestive heart failure [CHF]) or as composite outcomes (CVD or major adverse cardiovascular events [MACE]). Two hundred thirty-nine candidates had 421 CVD events and 120 people had 149 MACE over a median follow-up of 29 years. Age was the strongest risk factor for acute MI, silent MI, stroke, and PTCA/CABG, whereas glycemia was the strongest risk factor for CVD death, CHF, and angina, second strongest for acute MI and PTCA/CABG, third strongest for stroke, and not linked to silent MI. HbA1c was the strongest modifiable risk factor for both first and subsequent CVD events. To lower the risk of initial CVD events in T1D, intensive glycemic management is suggested. Optimal glycemic control can lessen the risk of recurrent CVD events after a first event and should be maintained.