Characteristics of Type 1 diabetes of over 50 years duration (the Golden Years Cohort)
| Autor: | P. H. Dyer, C. Smyth, A. H. Barnett, A. F. Jones, Geoff Gill, Stephen C. Bain, K. E. Jones, Moira Murphy |
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| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Genotype Endocrinology Diabetes and Metabolism Longevity Cataract Extraction Diabetic nephropathy Endocrinology Internal medicine Diabetes mellitus Internal Medicine medicine Albuminuria Humans Insulin Triglycerides Aged Glycated Hemoglobin Type 1 diabetes Proteinuria Diabetic Retinopathy business.industry Cholesterol HDL HLA-DR Antigens medicine.disease Thyroid Diseases Surgery Diabetes Mellitus Type 1 Cardiovascular Diseases Creatinine Cohort Hypertension Microalbuminuria Female Laser Therapy medicine.symptom business Kidney disease Cohort study Follow-Up Studies HLA-DRB1 Chains |
| Zdroj: | Diabetic medicine : a journal of the British Diabetic Association. 20(10) |
| ISSN: | 0742-3071 |
| Popis: | Background Type 1 diabetes mellitus is associated with high levels of premature morbidity and mortality. Prolonged survival is possible, however, and some patients appear to be protected from the long-term complications of this condition. Methods Diabetes UK awards medals to patients who have had Type 1 diabetes for 50 years or more. By examining medal-holders, we have established the clinical and biochemical features of a group of 400 subjects (54% male) with Type 1 diabetes of long duration. Results Mean age of the subjects was 68.9 years and mean age-at-onset of diabetes 13.7 years. Features of long duration diabetes in this cohort include normal body mass (mean BMI 25.0 kg m−2), low insulin dose (mean 0.52 units kg−2) and greatly elevated HDL-cholesterol (mean 1.84 mmol/l). Mean HbA1c was 7.6% (normal range 3.8–5.0%) and no patient had a normal HbA1c at the time of venesection. As a group, they have long-lived parents and consume moderate amounts of alcohol. Medical contact has often been sporadic. A significant proportion (29%) were taking anti-hypertensive medication. Screening for micro- and macroalbuminuria was positive in 35.7%. Conclusions Patients with long-duration (> 50 years) Type 1 diabetes are relatively protected from clinical diabetic nephropathy and large vessel disease; our data are consistent with protection possibly being genetically determined in part via elevated HDL-cholesterol levels. An abnormal urinary albumin/creatinine ratio is common in these patients, despite their low risk of significant renal deterioration; this may have implications for microalbuminuria screening programmes. |
| Databáze: | OpenAIRE |
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