Trends in HbA1c and other biochemical outcomes of individuals with newly diagnosed type 1 diabetes.
Cardiovascular risk factors
Complications
HbA1c
Type 1 diabetes
Journal
Irish journal of medical science
ISSN: 1863-4362
Titre abrégé: Ir J Med Sci
Pays: Ireland
ID NLM: 7806864
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
05
09
2020
accepted:
11
11
2020
pubmed:
25
11
2020
medline:
7
10
2021
entrez:
24
11
2020
Statut:
ppublish
Résumé
There is limited data on glycaemic control and cardiovascular risk factor management in newly diagnosed individuals with type 1 diabetes in the first 2 years. Retrospective, single centre study from the North West of England, newly diagnosed with type 1 diabetes between 2014 and 2018 (n = 58). HbA1c, blood pressure, lipids and body mass index (BMI) data were collected from electronic patient records from the time of diagnosis until the end of 2 years, stratified by age 16-24 years or ≥ 25 years at presentation. For those aged 16-24 years (n = 31), median (IQR), HbA1c improved at 6 months from 83 (63-93) to 51.5 (46-75) mmol/mol (p = 0.001) and remained stable 6-24 months. For those ≥ 25 years (n = 27), HbA1c declined from 91 (70-107) to 65 (50-89) mmol/mol, (p < 0.01) at 6 months and declined further to 52 mmol/mol (44-70) at 24 months. At 24 months, 27.8% of all individuals had an HbA1c ≥ 69 mmol/mol. Approximately, a third met LDL (< 2 mmol/L) and total cholesterol (< 4 mmol/L) targets. A total of 58.6% of individuals were overweight/obese (BMI > 25 kg/m In both age groups, significant improvement of HbA1c occurred within the first 6 months of diagnosis with no statistical difference between the two groups at any of the time points up to 24 months. Despite significant improvements in HbA1c, majority had levels > 53 mmol/mol at 24 months. Alongside the high incidence of obesity and dyslipidaemia, our data support the need for further intensification of therapy from diagnosis of type 1 diabetes.
Sections du résumé
BACKGROUND
BACKGROUND
There is limited data on glycaemic control and cardiovascular risk factor management in newly diagnosed individuals with type 1 diabetes in the first 2 years.
METHODS
METHODS
Retrospective, single centre study from the North West of England, newly diagnosed with type 1 diabetes between 2014 and 2018 (n = 58). HbA1c, blood pressure, lipids and body mass index (BMI) data were collected from electronic patient records from the time of diagnosis until the end of 2 years, stratified by age 16-24 years or ≥ 25 years at presentation.
RESULTS
RESULTS
For those aged 16-24 years (n = 31), median (IQR), HbA1c improved at 6 months from 83 (63-93) to 51.5 (46-75) mmol/mol (p = 0.001) and remained stable 6-24 months. For those ≥ 25 years (n = 27), HbA1c declined from 91 (70-107) to 65 (50-89) mmol/mol, (p < 0.01) at 6 months and declined further to 52 mmol/mol (44-70) at 24 months. At 24 months, 27.8% of all individuals had an HbA1c ≥ 69 mmol/mol. Approximately, a third met LDL (< 2 mmol/L) and total cholesterol (< 4 mmol/L) targets. A total of 58.6% of individuals were overweight/obese (BMI > 25 kg/m
CONCLUSIONS
CONCLUSIONS
In both age groups, significant improvement of HbA1c occurred within the first 6 months of diagnosis with no statistical difference between the two groups at any of the time points up to 24 months. Despite significant improvements in HbA1c, majority had levels > 53 mmol/mol at 24 months. Alongside the high incidence of obesity and dyslipidaemia, our data support the need for further intensification of therapy from diagnosis of type 1 diabetes.
Identifiants
pubmed: 33231831
doi: 10.1007/s11845-020-02434-w
pii: 10.1007/s11845-020-02434-w
pmc: PMC8302503
doi:
Substances chimiques
Blood Glucose
0
Glycated Hemoglobin A
0
hemoglobin A1c protein, human
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
999-1004Informations de copyright
© 2020. The Author(s).
Références
Diabetes Care. 2004 Jan;27 Suppl 1:S68-71
pubmed: 14693930
Lancet. 2014 Jan 4;383(9911):69-82
pubmed: 23890997
N Engl J Med. 2005 Dec 22;353(25):2643-53
pubmed: 16371630
Eur Heart J. 2020 Jan 7;41(2):255-323
pubmed: 31497854
N Engl J Med. 1993 Jul 29;329(5):304-9
pubmed: 8147960
J Diabetes Complications. 2018 Apr;32(4):411-417
pubmed: 29426748
Diabetes Care. 2016 Jun;39(6):996-1003
pubmed: 27208327
Diabetes Technol Ther. 2019 Feb;21(2):66-72
pubmed: 30657336
Pediatr Diabetes. 2018 Oct;19 Suppl 27:262-274
pubmed: 30079595
Diabetes Care. 2003 Apr;26(4):1270-6
pubmed: 12663609
Endocrinol Metab Clin North Am. 2010 Sep;39(3):625-40
pubmed: 20723824
Diabetes Care. 2016 Dec;39(12):2296-2303
pubmed: 27654986
Lancet. 2018 Aug 11;392(10146):477-486
pubmed: 30129464
Exp Clin Endocrinol Diabetes. 2017 May;125(5):297-300
pubmed: 28561193
Diabetes Care. 2018 Jan;41(Suppl 1):S55-S64
pubmed: 29222377