Enhancing nationwide awareness of cholesterol treatment in type 1 diabetes
Left to right: Dr Jonathan Hiew, Dr Emma Hamilton, Dr Nick Lan and Dr Ashley Leong
An estimated 9.5 million people worldwide lived with type 1 diabetes in 2025, which additionally put them at a higher risk of developing cardiovascular disease.
To improve the health of this population, Fiona Stanley Hospital (FSH) is leading phase two of a multi-centre research study to identify the barriers to cholesterol management in Australians with type 1 diabetes.
The initial Enhancing Nationwide Awareness of Cholesterol Treatment in Type 1 Diabetes (ENACT-T1D) study aimed to increase patient and clinician awareness to improve cholesterol management and reduce cardiovascular complications including heart attacks, strokes and peripheral vascular disease.
Phase two of the study will focus on a higher risk population of people with type 1 diabetes who also have diabetes-related foot ulcer disease.
FSH Cardiologist Dr Nick Lan said prior studies have found that fewer than half of adults with type 1 diabetes are reaching recommended LDL-cholesterol (‘bad cholesterol’) targets.
“The ENACT-T1D study seeks to understand how people with type 1 diabetes understand their heart disease risk, as well as their knowledge and perceptions about cholesterol and cholesterol-lowering medications,” Dr Lan said.
“Including people with diabetes-related foot ulcer disease to optimise cholesterol management in phase two of the study will add protection beyond standard wound and foot care, as well as support the development of targeted interventions for this high-risk population.”
“Further understanding of patient and system-level challenges in the study will help researchers design practical strategies to improve cholesterol care,” Dr Lan said.
The initial ENACT-T1D study was led by FSH Cardiologist Dr Nick Lan and FSH Endocrinologist, A/Prof Gerry Fegan, with FSH Podiatrists Dr Ashley Leong, Dr Jonathan Hiew and FSH Endocrinologist Dr Emma Hamilton undertaking the next phase, expecting completion by mid-2026.
Dr Nick and A/Prof Fegan are collaborating on the study with researchers in other states, including Professor Alicia Jenkins at the Baker Heart and Diabetes Institute in Melbourne. The ENACT-T1D surveys were developed with initial support from a Children's Diabetes Centre, Telethon Kids Institute seeding grant, and were published in the Internal Medicine Journal (external site) in November 2025
Keep up to date with our news and achievements
Find out more on Facebook (external site) or LinkedIn (external site)