Source: Diabetic Medicine; Mar 2017; vol. 34 ; p. 146
Publication Type(s): Journal: Conference Abstract
Available in full text at Diabetic Medicine - from John Wiley and Sons
Abstract:Aims: To ascertain the body weight, body mass index (BMI) and comorbidities of adults with newly diagnosed Type 1 diabetes and assess the impact of initiating insulin therapy over the first 5 years after diagnosis. Methods: This was a non-interventional, retrospective, cohort study utilising data from the UK Clinical Practice Research Datalink database between 2001 and 2013. Included patients were aged 18-85 years, with a BMI of 11-50kg/m2 and a full medical history of >12 months prior to diagnosis. Glycated haemoglobin (HbA1c) and BMI levels were compared at baseline and 12, 24, 36 and 60 months after initiation of insulin therapy. Results: At baseline, patients had a mean +/- SD age of 40.8 +/- 16.1 years, HbA1c of 10.8 +/- 3.0%, and a BMI of 25.3 +/- 5.5kg/m2. Following initiation of insulin therapy, mean HbA1c declined from 10.8 +/- 3.0% to 7.7 +/- 2.0% at 12 months (p < 0.01), but subsequently increased to 8.1 +/- 2.0% at 24 months, remaining stable thereafter. Mean BMI consistently increased from 25.3 +/- 5.5 at baseline to 27.2 +/- 5.8, 27.4 +/- 5.7, 27.5 +/- 5.6, and 27.9 +/- 5.5kg/ m2 at 1, 2, 3 and 5 years, respectively. Conclusions: Whilst insulin therapy exerted an initial reduction in HbA1c at 12 months, mean HbA1c at 12 months was still above the National Institute for Health and Care Excellence (NICE) targets, and further deteriorated soon after. After beginning insulin therapy, patients with Type 1 diabetes were susceptible to longterm cumulative weight gain and increase in BMI. This study illustrates the need for greater emphasis on weight management in national Type 1 diabetes education programmes.