Characteristics of newly diagnosed adults with type 1 diabetes in the UK and evolution of glycaemic control, body mass index and Charlson comorbidity index over the first 5 years after diagnosis.

Autor: Ramtoola S; Department of Diabetes, Royal Blackburn Hospital, Blackburn, United Kingdom. Electronic address: Shenaz.Ramtoola@elht.nhs.uk., Nyeland ME; Novo Nordisk A/S, Copenhagen, Denmark., Jacobsen J; Statcon ApS, Kokkedal, Denmark., Ploug UJ; Novo Nordisk A/S, Copenhagen, Denmark., Kragh N; Novo Nordisk A/S, Copenhagen, Denmark., Zimmermann E; Novo Nordisk A/S, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Primary care diabetes [Prim Care Diabetes] 2020 Aug; Vol. 14 (4), pp. 349-355. Date of Electronic Publication: 2019 Oct 26.
DOI: 10.1016/j.pcd.2019.09.009
Abstrakt: Aims: This retrospective, longitudinal study characterised 2430 adults (mean age 40.8±16.1years) with newly diagnosed type 1 diabetes (T1D) over the first 5years of insulin treatment.
Methods: Data from 1year pre- and up to 5 years post-insulin initiation were extracted from the UK Clinical Practice Research Datalink (1990-2013). Baseline HbA 1c , BMI and Charlson comorbidity index (CCI) score were compared with data at 1, 2, 3 and 5 years.
Results: Mean HbA 1c decreased significantly from baseline 95±32.8mmol/mol (10.8±3.0%) to 61±21.9mmol/mol (7.7±2.0%) at 1year, remaining significantly lower at 2, 3 and 5 years (p<0.0001). One year after initiating insulin, only 6.3% of patients had HbA 1c <48mmol/mol (<6.5%). There was no further improvement in HbA1c after 1year. Mean BMI increased significantly from baseline 25.3±5.5kg/m 2 to 27.2±5.8kg/m 2 at 1year; p<0.0001), remaining significantly higher thereafter, with over two-thirds having overweight/obesity by year 5. Mean CCI score increased significantly (1.32, baseline; 1.46, year 1; 1.75, year 5). CCI patterns were similar within BMI and HbA 1c strata.
Conclusions: More intensive support to reach and maintain glycaemic targets soon post-diagnosis, while avoiding weight gain, and prevention and optimal management of comorbidities are warranted.
(Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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