Loss of association between HbA1c and vascular disease in older adults with type 1 diabetes

Autor: Nick Oliver, HaEun Ji, Neil E. Hill, Ian F. Godsland
Rok vydání: 2019
Předmět:
Blood Glucose
Male
Pediatrics
Epidemiology
Blood Pressure
030204 cardiovascular system & hematology
Logistic regression
Biochemistry
Vascular Medicine
chemistry.chemical_compound
0302 clinical medicine
Endocrinology
Elderly
Risk Factors
Diabetes diagnosis and management
Medicine
Insulin
Longitudinal Studies
Aged
80 and over
COMPLICATIONS
Multidisciplinary
Glycemic Load
Middle Aged
Lipids
Multidisciplinary Sciences
Cholesterol
Hypertension
Science & Technology - Other Topics
Female
Research Article
Adult
medicine.medical_specialty
HbA1c
General Science & Technology
Endocrine Disorders
Science
030209 endocrinology & metabolism
03 medical and health sciences
Young Adult
Diabetes mellitus
Diabetes Mellitus
Humans
Hypoglycemic Agents
Obesity
Hemoglobin
Vascular Diseases
Risk factor
Aged
Glycated Hemoglobin
Medicine and health sciences
Type 1 diabetes
Science & Technology
Biology and life sciences
business.industry
Vascular disease
nutritional and metabolic diseases
Proteins
medicine.disease
Diagnostic medicine
Diabetes Mellitus
Type 1
chemistry
Diabetes Mellitus
Type 2
Age Groups
Metabolic Disorders
People and Places
Population Groupings
business
Diabetic Angiopathies
Zdroj: PLoS ONE
PLoS ONE, Vol 15, Iss 6, p e0234319 (2020)
ISSN: 1932-6203
Popis: AimsRobust evidence supports intensive glucose control in those with recently diagnosed type 1 diabetes to reduce the risk of developing micro- and macrovascular complications. Data to support longitudinal glycaemic targets is lacking. We aimed to explore if longer duration of diabetes and greater age might reduce the impact of glycaemia on the risk of vascular complications.Research and design methodsData for adults age 20 years or more, was extracted from a clinical database of people with type 1 diabetes cared for at a London teaching hospital. The presence or absence of micro- and macro-vascular complications was recorded. Multivariable logistic regression analysis was performed using HbA1c as independent variable, diabetes duration and age as continuous variable and obesity, hypertension, hypercholesterolaemia, low HDL cholesterol and hypertriglyceridaemia as categorical variables.ResultsData from 495 patients was used. HbA1c above 60 mmol/mol (7.6%) was associated with increased microvascular complications in patients aged 20-44 years, independent of age and duration of diabetes. In older people with T1DM duration of diabetes was the major risk factor.ConclusionsOur study suggests that increased age and greater duration of diabetes reduce the impact of glycaemia on the risk of vascular complications. Intensive blood glucose management in patients aged ≥45 years may have limited benefits in terms of reducing the risk of complications although this does not dismiss the benefits of good glycaemic control in older people with T1DM.
Databáze: OpenAIRE
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