Abstract
Background: Despite major medical advances, Type 1 Diabetes (T1D) patients still have greater morbimortality than the general population. Our aim was to describe our cohort of T1D patients and identify potential risk factors susceptible to prevention strategies. Methods: Cross-sectional, observational study, including T1D patients treated at our center, from 1 March 2017 to 31 March 2020. Inclusion criteria: T1D, age > 14 years and signed informed consent. Exclusion criteria: diabetes other than T1D, age < 14 years and/or refusal to participate. Results: Study population n = 2181 (49.8% females, median age at enrollment 41 years, median HbA1c 7.7%; 38.24% had at least one comorbidity). Roughly 7.45% had severe hypoglycemia (SH) within the prior year. Macro/microvascular complications were present in 42.09% (5.83% and 41.14%, respectively). The most frequent microvascular complication was diabetic retinopathy (38.02%), and coronary disease (3.21%) was the most frequent macrovascular complication. The risk of complications was higher in males than in females, mainly macrovascular. Patients with SH had a higher risk of complications (OR 1.42; 1.43 in males versus 1.42 in females). Conclusions: Our T1D population is similar to other T1D populations. We should minimize the risk of SH, and male patients should perhaps be treated more aggressively regarding cardiovascular risk factors.
Highlights
Type 1 Diabetes (T1D) is a chronic disease highly associated with comorbidity and microvascular complications, and until 1921, with the discovery of insulin, the disease was fatal
The incidence of these complications has been sharply reduced. This is due to lipid-lowering drugs and angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, and to the advent of intensive insulin therapy as a standard treatment for all patients with T1D following the results of the Diabetes Control and Complications Trial and the Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study [5], as well as the use of advanced treatment options such as continuous infusion pumps, continuous glucose monitoring systems, new insulin analogues with better profiles and, more recently, hybrid closed-loop systems
We do not have data on smoking in our cohort, it seems that our patients might have a higher cardiovascular risk in comparison with the SED1 cohort, but are similar to the Portuguese T1D patients reported by Madeira et al [22]
Summary
Type 1 Diabetes (T1D) is a chronic disease highly associated with comorbidity and microvascular complications, and until 1921, with the discovery of insulin, the disease was fatal. The incidence of these complications has been sharply reduced This is due to lipid-lowering drugs and angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, and to the advent of intensive insulin therapy as a standard treatment for all patients with T1D following the results of the Diabetes Control and Complications Trial and the Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study [5], as well as the use of advanced treatment options such as continuous infusion pumps, continuous glucose monitoring systems, new insulin analogues with better profiles and, more recently, hybrid closed-loop systems. We should minimize the risk of SH, and male patients should perhaps be treated more aggressively regarding cardiovascular risk factors
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