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Risk of future microvascular and macrovascular disease in people with Type 1 diabetes of very long duration : A national study with 10-year follow-up

Eryd, S. A.; Svensson, A. M.; Franzén, S.; Eliasson, B.; Nilsson, P. M. LU and Gudbjörnsdottir, S. (2017) In Diabetic Medicine 34(3). p.411-418
Abstract

Aims: To describe factors associated with prevalence or absence of microvascular and macrovascular complications in people with Type 1 diabetes of very long duration and to investigate the risk factors associated with the incidence of such complications. Methods: We included individuals with Type 1 diabetes who had been entered in the Swedish National Diabetes Register between 2002 and 2004 (n = 18 450). First, risk factor distribution in people with diabetes duration of ≥ 50 years was compared between people with and without complications. Second, the incidence of complications during a 10-year follow-up period was studied in all individuals who had no complications at baseline. Results: Among people with a diabetes duration of ≥ 50... (More)

Aims: To describe factors associated with prevalence or absence of microvascular and macrovascular complications in people with Type 1 diabetes of very long duration and to investigate the risk factors associated with the incidence of such complications. Methods: We included individuals with Type 1 diabetes who had been entered in the Swedish National Diabetes Register between 2002 and 2004 (n = 18 450). First, risk factor distribution in people with diabetes duration of ≥ 50 years was compared between people with and without complications. Second, the incidence of complications during a 10-year follow-up period was studied in all individuals who had no complications at baseline. Results: Among people with a diabetes duration of ≥ 50 years (n = 1023), 453 (44%) had macrovascular disease, 534 (52%) had microvascular disease and 319 (31%) did not have either of the diagnoses. Factors that differed significantly between people with and without macrovascular disease were gender, age, HbA1c, BMI, LDL cholesterol, HDL cholesterol, triglycerides, systolic blood pressure, albuminuria, antihypertensive medication and lipid-lowering medication. The same factors differed significantly between people with and without microvascular disease, with the exception of gender and HDL cholesterol. During the follow-up period, 6.1% of the study cohort were diagnosed with macrovascular disease and 19.6% with microvascular disease. Incidence of macrovascular disease was significantly associated with HbA1c levels. Hazard ratios decreased with longer diabetes duration. Conclusions: People with Type 1 diabetes who have survived ≥ 50 years without complications are significantly younger, and have significantly lower HbA1c levels, BMI and triglyceride levels than survivors with complications. HbA1c level is a predictor of macrovascular disease, independently of diabetes duration.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Diabetic Medicine
volume
34
issue
3
pages
411 - 418
publisher
Wiley-Blackwell
external identifiers
  • scopus:84995466511
  • wos:000397404200014
ISSN
0742-3071
DOI
10.1111/dme.13266
language
English
LU publication?
yes
id
3d537551-55a4-42c3-8131-5fb434e262be
date added to LUP
2016-12-05 09:03:53
date last changed
2018-01-07 11:38:40
@article{3d537551-55a4-42c3-8131-5fb434e262be,
  abstract     = {<p>Aims: To describe factors associated with prevalence or absence of microvascular and macrovascular complications in people with Type 1 diabetes of very long duration and to investigate the risk factors associated with the incidence of such complications. Methods: We included individuals with Type 1 diabetes who had been entered in the Swedish National Diabetes Register between 2002 and 2004 (n = 18 450). First, risk factor distribution in people with diabetes duration of ≥ 50 years was compared between people with and without complications. Second, the incidence of complications during a 10-year follow-up period was studied in all individuals who had no complications at baseline. Results: Among people with a diabetes duration of ≥ 50 years (n = 1023), 453 (44%) had macrovascular disease, 534 (52%) had microvascular disease and 319 (31%) did not have either of the diagnoses. Factors that differed significantly between people with and without macrovascular disease were gender, age, HbA<sub>1c</sub>, BMI, LDL cholesterol, HDL cholesterol, triglycerides, systolic blood pressure, albuminuria, antihypertensive medication and lipid-lowering medication. The same factors differed significantly between people with and without microvascular disease, with the exception of gender and HDL cholesterol. During the follow-up period, 6.1% of the study cohort were diagnosed with macrovascular disease and 19.6% with microvascular disease. Incidence of macrovascular disease was significantly associated with HbA<sub>1c</sub> levels. Hazard ratios decreased with longer diabetes duration. Conclusions: People with Type 1 diabetes who have survived ≥ 50 years without complications are significantly younger, and have significantly lower HbA<sub>1c</sub> levels, BMI and triglyceride levels than survivors with complications. HbA<sub>1c</sub> level is a predictor of macrovascular disease, independently of diabetes duration.</p>},
  author       = {Eryd, S. A. and Svensson, A. M. and Franzén, S. and Eliasson, B. and Nilsson, P. M. and Gudbjörnsdottir, S.},
  issn         = {0742-3071},
  language     = {eng},
  number       = {3},
  pages        = {411--418},
  publisher    = {Wiley-Blackwell},
  series       = {Diabetic Medicine},
  title        = {Risk of future microvascular and macrovascular disease in people with Type 1 diabetes of very long duration : A national study with 10-year follow-up},
  url          = {http://dx.doi.org/10.1111/dme.13266},
  volume       = {34},
  year         = {2017},
}