Clinical Characteristics and Degree of Glycemic and Cardiovascular Risk Factor Control in Patients with Type 1 Diabetes in Catalonia (Spain).

cardiovascular risk factors complications glucose control type-1 diabetes

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
06 Apr 2021
Historique:
received: 31 01 2021
revised: 19 03 2021
accepted: 26 03 2021
entrez: 30 4 2021
pubmed: 1 5 2021
medline: 1 5 2021
Statut: epublish

Résumé

This study aims to evaluate the clinical characteristics, complications, degree of glycemic control, and cardiovascular risk factor control in patients with type 1 diabetes in Catalonia (Northwest of Spain). Cross-sectional study using a database including clinical, laboratory, and treatment data. Patients with an ICD10 diagnosis of type 1 diabetes were included, excluding those treated with glucose-lowering agents other than insulin, or treated only with basal insulin two years after diagnosis. 15,008 patients were analysed. Median IQR age was 42 (31-53) years, diabetes duration 11.8 (6.8-16.0) years, 56.5% men. Median (IQR) HbA1c was 7.9% (7.1-8.8). Microvascular complications were present in 24.4% of patients, 43.6% in those with a diabetes duration >19 years. In presence of known cardiovascular disease 69.3% of patients showed an LDL-C concentration >70 mg/dL, 37% had a systolic blood pressure >135 mmHg and 22.4% were smokers. This study provides a reliable snapshot about the clinical situation of a large population of patients with T1D in Catalonia, which is similar to that of other western areas. The lack of adequate control of cardiovascular risk factors in a significant proportion of patients with cardiovascular disease deserves a more detailed analysis and urges the need for improvement strategies.

Sections du résumé

BACKGROUND BACKGROUND
This study aims to evaluate the clinical characteristics, complications, degree of glycemic control, and cardiovascular risk factor control in patients with type 1 diabetes in Catalonia (Northwest of Spain).
METHODS METHODS
Cross-sectional study using a database including clinical, laboratory, and treatment data. Patients with an ICD10 diagnosis of type 1 diabetes were included, excluding those treated with glucose-lowering agents other than insulin, or treated only with basal insulin two years after diagnosis.
RESULTS RESULTS
15,008 patients were analysed. Median IQR age was 42 (31-53) years, diabetes duration 11.8 (6.8-16.0) years, 56.5% men. Median (IQR) HbA1c was 7.9% (7.1-8.8). Microvascular complications were present in 24.4% of patients, 43.6% in those with a diabetes duration >19 years. In presence of known cardiovascular disease 69.3% of patients showed an LDL-C concentration >70 mg/dL, 37% had a systolic blood pressure >135 mmHg and 22.4% were smokers.
CONCLUSIONS CONCLUSIONS
This study provides a reliable snapshot about the clinical situation of a large population of patients with T1D in Catalonia, which is similar to that of other western areas. The lack of adequate control of cardiovascular risk factors in a significant proportion of patients with cardiovascular disease deserves a more detailed analysis and urges the need for improvement strategies.

Identifiants

pubmed: 33917523
pii: jcm10071536
doi: 10.3390/jcm10071536
pmc: PMC8038775
pii:
doi:

Types de publication

Journal Article

Langues

eng

Subventions

Organisme : Lilly S.A. Spain
ID : NA

Références

Cochrane Database Syst Rev. 2014 Feb 14;(2):CD009122
pubmed: 24526393
N Engl J Med. 2005 Dec 22;353(25):2643-53
pubmed: 16371630
Ther Adv Endocrinol Metab. 2019 Feb 28;10:2042018819830867
pubmed: 30834104
Diabetes. 2019 Feb;68(2):409-419
pubmed: 30409781
BMJ Open. 2017 Feb 28;7(2):e014444
pubmed: 28246144
Diabetes Res Clin Pract. 2016 Jan;111:51-7
pubmed: 26597211
Diabetes Res Clin Pract. 2019 Nov;157:107842
pubmed: 31518658
Eur Heart J. 2018 Apr 7;39(14):1172-1180
pubmed: 29069377
Circulation. 2016 Mar 15;133(11):1058-66
pubmed: 26888765
Diabetes Care. 2012 Apr;35(4):774-9
pubmed: 22344609
Med Clin (Barc). 2009 Apr 4;132(12):454-8
pubmed: 19303112
Diabet Med. 2012 Feb;29(2):181-9
pubmed: 21883428
Diabetes Care. 2019 Jan;42(Suppl 1):S103-S123
pubmed: 30559236
Endocrinol Nutr. 2016 Apr;63(4):157-63
pubmed: 26948542
Diabetes Care. 2019 May;42(5):875-882
pubmed: 30833368
Diabetes Obes Metab. 2018 Aug;20(8):1965-1971
pubmed: 29687581
Lancet. 2016 Mar 5;387(10022):957-967
pubmed: 26724178
Diabetes Care. 2019 Jan;42(Suppl 1):S61-S70
pubmed: 30559232
BMJ Open. 2016 Oct 5;6(10):e012463
pubmed: 27707830
Diabetes Res Clin Pract. 2019 May;151:224-230
pubmed: 31004670
PLoS One. 2016 Nov 3;11(11):e0164977
pubmed: 27812145
Pediatr Diabetes. 2007 Dec;8(6):369-73
pubmed: 18036062
Diabetes Res Clin Pract. 2016 May;115:9-16
pubmed: 27242117
Diabetes Care. 2014 Oct;37(10):2843-63
pubmed: 25114297
Lancet. 2018 Aug 11;392(10146):477-486
pubmed: 30129464
Diabetes Obes Metab. 2006 Nov;8(6):682-9
pubmed: 17026493
J Intern Med. 2017 Mar;281(3):261-272
pubmed: 27925333
Diabetes Care. 1996 Jul;19(7):689-97
pubmed: 8799621
PLoS One. 2017 Mar 31;12(3):e0174979
pubmed: 28362881
Circulation. 2019 Apr 16;139(16):1900-1912
pubmed: 30798638
Diabetes Care. 2019 Dec;42(12):2220-2227
pubmed: 31548241
Diabetes Technol Ther. 2019 Feb;21(2):66-72
pubmed: 30657336
Diabetes Obes Metab. 2020 Apr;22(4):622-630
pubmed: 31789439
Diabetologia. 1992 Mar;35(3):267-71
pubmed: 1563583
Atherosclerosis. 2019 Nov;290:140-205
pubmed: 31591002

Auteurs

Gabriel Gimenez-Perez (G)

Endocrinology Unit, Department of Medicine, Hospital General de Granollers, 08402 Granollers, Spain.

Josep Franch-Nadal (J)

DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain.
CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Barcelona, Spain.
Primary Health Care Centre Raval Sud, Gerència d'Atenció Primària Barcelona Ciutat, Institut Català de la Salut, 08001 Barcelona, Spain.

Emilio Ortega (E)

Department of Endocrinology & Nutrition, Institut d'Investigacions Biomèdiques August Pi Suñer, CIBEROBN, Hospital Clínic Barcelona, 08036 Barcelona, Spain.

Manel Mata-Cases (M)

DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain.
CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Barcelona, Spain.
Primary Health Care Centre La Mina, Gerència d'Atenció Primària Barcelona Ciutat, Institut Català de la Salut, 08930 Sant Adrià del Besós, Spain.

Albert Goday (A)

Department of Endocrinology & Nutrition, Hospital del Mar, 08003 Barcelona, Spain.
Department of Medicine, Universitat Autònoma de Barcelona, CIBEROBN, 08193 Barcelona, Spain.

Jordi Real (J)

DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain.
CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Barcelona, Spain.

Angel Rodriguez (A)

Department of Clinical Research, Lilly, S.A., 28108 Madrid, Spain.

Bogdan Vlacho (B)

DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain.

Dídac Mauricio (D)

DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain.
CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Barcelona, Spain.
Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain.
Faculty of Medicine, University of Vic-Central University of Catalonia, 08500 Vic, Spain.

Classifications MeSH