INS and atherosclerosis: Landmark trials show that intensive insulin therapy reduces cardiovascular events in adults.6, 49 Although differences in HbA1c account for most of this benefit, multivariate analyses suggest that part of the reduced risk is mediated by reduction in the incidence of diabetic renal disease.50 In children and young people with T1D, atherosclerosis is present to a greater extent51 and the prevalence of cardiovascular risk factors is greater52, 53 than in the general population.