Progression of Diabetic Complications in Subgroups of People with Long Term Diabetes Type 1 According to Clinical Course.
Exp Clin Endocrinol Diabetes
; 130(2): 101-109, 2022 Feb.
Article
in En
| MEDLINE
| ID: mdl-32777840
ABSTRACT
AIMS:
Prevention and prediction of microvascular complications are important aims of medical care in people with type 1 diabetes. Since the course of the disease is heterogenous, we tried to identify subgroups with specific risk profiles for microvascular complications.METHODS:
Retrospective analysis of a cohort of 285 people (22637 consultations) with >10 years of type 1 diabetes. Persons were grouped into slow (<15 years), fast (>15 years) and non progressors according to the average onset of microvascular complications. Generalized estimating equations for binary outcomes were applied and pseudo coefficients of determination were calculated.RESULTS:
Progression to microvascular disease was associated with age (OR 1.034 [1.001-1.068]; p=0.04), diabetes duration (OR 1.057 [1.021-1.094]; p=0.002), HbA1c (OR 1.035 [1.011-1.060]; p=0.005), BMI (OR 0.928 [0.866-0.994]; p=0.034) and the social strata index (OR 0.910 [0.830-0.998]; p=0.046). Generalized estimating equations predicted 31.02% and exclusion of HbA1c marginally reduced the value to 28.88%. The proportion of patients with LADA was higher in fast than slow progressors [13 (26.5%) vs. 14 (11.9%); p=0.019]. A generalized estimating equation comparing slow to fast progressors revealed no significant markers.CONCLUSION:
In our analysis, we were able to confirm known risk factors for microvascular disease in people with type 1 diabetes. Overall, prediction of individual risk was difficult, the effect of individual markers minor and we could not find differences regarding slow or fast progression. We therefore emphasis the need for additional markers to predict individual risk for microvascular disease.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Social Class
/
Disease Progression
/
Diabetes Mellitus, Type 1
/
Diabetic Angiopathies
/
Microvessels
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Determinantes_sociais_saude
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Exp Clin Endocrinol Diabetes
Journal subject:
ENDOCRINOLOGIA
Year:
2022
Document type:
Article
Affiliation country:
Germany