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
Author(s) Ramtoola S.; Nyeland M.E.; Ploug U.J.; Kragh N.; Zimmermann E. et al.
Source Primary Care Diabetes; 2019
Aims: This retrospective, longitudinal study characterised 2430 adults (mean age 40.8 +/- 16.1 years) with newly diagnosed type 1 diabetes (T1D) over the first 5 years of insulin treatment.
Method(s): Data from 1 year pre- and up to 5 years post-insulin initiation were extracted from the UK Clinical Practice Research Datalink (1990-2013). Baseline HbA1c, BMI and Charlson comorbidity index (CCI) score were compared with data at 1, 2, 3 and 5 years. Result(s): Mean HbA1c decreased significantly from baseline 95 +/- 32.8 mmol/mol (10.8 +/- 3.0%) to 61 +/- 21.9 mmol/mol (7.7 +/- 2.0%) at 1 year, remaining significantly lower at 2, 3 and 5 years (p < 0.0001). One year after initiating insulin, only 6.3% of patients had HbA1c<48 mmol/mol (<6.5%). There was no further improvement in HbA1c after 1 year. Mean BMI increased significantly from baseline 25.3 +/- 5.5 kg/m2 to 27.2 +/- 5.8 kg/m2 at 1 year; 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 HbA1c strata.
Conclusion(s): 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
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