Abstract
BackgroundThere is limited data on glycaemic control and cardiovascular risk factor management in newly diagnosed individuals with type 1 diabetes in the first 2 years.MethodsRetrospective, single centre study from the North West of England, newly diagnosed with type 1 diabetes between 2014 and 2018 (n = 58). HbA1c, blood pressure, lipids and body mass index (BMI) data were collected from electronic patient records from the time of diagnosis until the end of 2 years, stratified by age 16–24 years or ≥ 25 years at presentation.ResultsFor those aged 16–24 years (n = 31), median (IQR), HbA1c improved at 6 months from 83 (63–93) to 51.5 (46–75) mmol/mol (p = 0.001) and remained stable 6–24 months. For those ≥ 25 years (n = 27), HbA1c declined from 91 (70–107) to 65 (50–89) mmol/mol, (p < 0.01) at 6 months and declined further to 52 mmol/mol (44–70) at 24 months. At 24 months, 27.8% of all individuals had an HbA1c ≥ 69 mmol/mol. Approximately, a third met LDL (< 2 mmol/L) and total cholesterol (< 4 mmol/L) targets. A total of 58.6% of individuals were overweight/obese (BMI > 25 kg/m2) at 24 months compared to 45.8% at baseline. There were no significant blood pressure changes during the follow-up.ConclusionsIn both age groups, significant improvement of HbA1c occurred within the first 6 months of diagnosis with no statistical difference between the two groups at any of the time points up to 24 months. Despite significant improvements in HbA1c, majority had levels > 53 mmol/mol at 24 months. Alongside the high incidence of obesity and dyslipidaemia, our data support the need for further intensification of therapy from diagnosis of type 1 diabetes.
Highlights
Diabetes is one of the most common chronic medical conditions in Europe
Median haemoglobin A1c (HbA1c) at diagnosis was higher in the older cohort than the younger (91 vs 83 mmol/mol) but did not reach statistical significance (p = 0.143). (Table 2) the older group had higher median HbA1c levels during the initial 12 months of the study period compared to the younger group, without statistical significance
We describe the changes in HbA1c and other cardiovascular risk factors in a cohort of patients with newly diagnosed type 1 diabetes presenting between 2014 and 2018 at a single centre followed up for 24 months
Summary
Relative to the adult population, the incidence of new onset type 1 diabetes (T1DM) is higher in adolescents but the prevalence is increasing in all age groups.[1]. The National Institute for Health and Care Excellence (NICE) in the UK recommends a target HbA1c of < 48 mmol/mol for both children and adults to minimise the risk of developing complications.[3] Whereas in the USA, the American Diabetes Association (ADA) recommends a target < 58 mmol/mol for children and < 53 mmol/mol for adults.[4] Individuals with diabetes are at higher risk of cardiovascular. There is limited data on glycaemic control and cardiovascular risk factor management in newly diagnosed individuals with type 1 diabetes in the first 2 years
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