Description of a Cohort of Type 1 Diabetes Patients: Analysis of Comorbidities, Prevalence of Complications and Risk of Hypoglycemia

Abstract

Background: Despite major medical advances, Type 1 Diabetes (T1D) patients still have greater morbimortality than the general population. Our aim was to describe our cohort of T1D patients and identify potential risk factors susceptible to prevention strategies. Methods: Cross-sectional, observational study, including T1D patients treated at our center, from 1 March 2017 to 31 March 2020. Inclusion criteria: T1D, age > 14 years and signed informed consent. Exclusion criteria: diabetes other than T1D, age < 14 years and/or refusal to participate. Results: Study population n = 2181 (49.8% females, median age at enrollment 41 years, median HbA1c 7.7%; 38.24% had at least one comorbidity). Roughly 7.45% had severe hypoglycemia (SH) within the prior year. Macro/microvascular complications were present in 42.09% (5.83% and 41.14%, respectively). The most frequent microvascular complication was diabetic retinopathy (38.02%), and coronary disease (3.21%) was the most frequent macrovascular complication. The risk of complications was higher in males than in females, mainly macrovascular. Patients with SH had a higher risk of complications (OR 1.42; 1.43 in males versus 1.42 in females). Conclusions: Our T1D population is similar to other T1D populations. We should minimize the risk of SH, and male patients should perhaps be treated more aggressively regarding cardiovascular risk factors.

Early Retinal Microvascular Changes Assessed with Swept-Source OCT Angiography in Type 1 Diabetes Patients without Retinopathy

“…Finally, the median age of our diabetes group was close to 30 years. The risk of microvascular and macrovascular complications linked to diabetes increases with age, but it appears that this risk is particularly low before the age of 20 years [ 29 ]. In the present study, the few statistically significant differences found in the OCT-A parameters could be influenced by the young age of our population.…”

Diabetes mellitus: what the neurologists need to know

“…At the time of diagnosis, one study observed in people with T2DM, the prevalence to be coronary artery disease (7.0%), heart failure (3.5%), cerebrovascular disease (1.2%) and peripheral artery disease (2.2%) 48. Similarly in people with T1DM, the observed prevalence was coronary heart disease (3.2%), cerebrovascular disease (1.6%), and peripheral artery disease (2.5%), though naturally this risk increases with the duration of diabetes 49. Cardiovascular or cerebrovascular disease screening is not indicated in diabetes, however, NICE recommends annual foot screening for peripheral vascular disease and annual HbA1c and serum cholesterol to support management of cardiovascular risk factors 50.…”

“…Indeed, at the time of T2DM diagnosis the prevalence is chronic kidney disease (12.3%), proliferative retinopathy (0.3%) and peripheral neuropathy (3.8%) 48. In people with T1DM, one study reported the prevalence of retinopathy at 38.0%, nephropathy in 13.5% and neuropathy in 8.1% 49. NICE recommends annual retinal screening, annual renal function and urinary albumin-to-creatinine ratio, and annual foot examination to evaluate for microvascular complications 30 31.…”

Body composition and sexual hormones for the glucose control of autoimmune diabetes in males: are they necessary to predict diabetes-related complications?

“…Appropriate glucose control is essential for patients with autoimmune diabetes, in order to avoid microvascular and macrovascular complications. According to a large, recent study in Spanish population, microvascular and macrovascular complications affect 41.14% and 5.83% of patients with type 1 diabetes (T1DM) respectively ( 1 ); the same is observed in 23.1% and 4.9% of patients with late autoimmune diabetes of the adulthood (LADA) respectively ( 2 ), these complications are associated with decreased quality of life and increased mortality and medical costs.…”

“…Both micro and macrovascular complications are more prevalent in males ( 1 , 3 ). Several factors have been associated with the presence of these complications, specifically, the time of duration of diabetes, glucose control and glucose variability among others ( 4 ).…”