Teenagers with poor metabolic control already have a higher risk of microvascular complications as young adults

Abstract

AimsTo evaluate how HbA1c in adolescents with type 1 diabetes affects microvascular complications in young adults. MethodsAll individuals registered in the Swedish paediatric diabetes quality registry (SWEDIABKIDS) 13–18 years of age, and as adults registered in the Swedish National Diabetes Registry (NDR) in both the years 2011 and 2012 were included, in total 4250 individuals. ResultsOf the individuals with mean HbA1c >78mmol/mol in SWEDIABKIDS 83.4% had retinopathy, 15.8% had microalbuminuria and 4.9% had macroalbuminuria in NDR. The logistic regression analysis showed that the OR to develop macroalbuminuria as a young adult was significantly higher in the group with mean HbA1c >78mmol/mol in SWEDIABKIDS (p<0.05). Among the patients with mean HbA1c above 78mmol/mol in both registries there was a significantly higher proportion that had retinopathy, microalbuminuria (p<0.001) and/or macroalbuminuria (p<0.01) compared to the group with HbA1c below 57mmol/mol in both registries. Only 6.5% of the persons in this study were over 30years of age. ConclusionsPaediatric diabetes teams working with teenagers must be aware of the impact of good metabolic control during adolescence, and should intensify the care during this vulnerable period of life to reduce the risk of microvascular complications in young adults.