Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Effect of duration and burden of microvascular complications on mortality rate in type 1 diabetes: an observational clinical cohort study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. GLP-1 secretion is regulated by IL-6 signalling: a randomised, placebo-controlled study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Circulating metabolites in progression to islet autoimmunity and type 1 diabetes

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Fenofibrate increases very-long-chain sphingolipids and improves blood glucose homeostasis in NOD mice

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Role of fasting duration and weekday in incretin and glucose regulation

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Estimates of prediabetes and undiagnosed type 2 diabetes in Denmark: The end of an epidemic or a diagnostic artefact?

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Habitual activity associates with lower fasting and greater glucose-induced GLP-1 response in men

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Optos wide-field imaging versus conventional camera imaging in Danish patients with type 2 diabetes

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

AIMS/HYPOTHESIS: The role of burden and duration of multiple microvascular complications on mortality rate has not been explored in detail in type 1 diabetes. Taking complication burden and time-updated duration into account we aimed to quantify mortality rate in individuals with and without microvascular complications.

METHODS: This observational clinical cohort included 3828 individuals with type 1 diabetes attending the Steno Diabetes Center Copenhagen in 2001-2013. We used information on mortality and detailed clinical measures of microvascular complications from electronic patient records. Poisson models were used to model mortality rates according to complication burden.

RESULTS: During 26,665 person-years of follow-up, 503 deaths occurred. Compared with individuals without microvascular complications, the mortality rate ratio was 2.20 (95% CI 1.79, 2.69) for individuals with diabetic kidney disease, 1.72 (95% CI 1.39, 2.12) for individuals with neuropathy and 1.02 (95% CI 0.77, 1.37) for individuals with retinopathy, all adjusted for calendar time (year/month/day), age, duration of diabetes, sex, HbA1c, LDL-cholesterol, BMI, smoking status, systolic blood pressure, use of antihypertensive and lipid-lowering medication, and cardiovascular disease status. In individuals with two complications or more, the risk of mortality did not exceed the combined risk from each individual complication. Mortality rate ratios increased immediately after diagnosis of neuropathy and diabetic kidney disease. Mortality rate ratios were independent of the duration of neuropathy and retinopathy, while the mortality rate associated with diabetic kidney disease reached a stable level after approximately 3 years.

CONCLUSIONS/INTERPRETATION: Neuropathy and diabetic kidney disease are strong and independent risk markers of mortality in type 1 diabetes, whereas no evidence of higher mortality rate was found for retinopathy. We found no indication that the mortality risk with multiple complications exceeds the risk conferred by each complication separately. The duration spent with microvascular complications had only a marginal effect on mortality.

OriginalsprogEngelsk
TidsskriftDiabetologia
Vol/bind62
Udgave nummer4
Sider (fra-til)633-643
Antal sider11
ISSN0012-186X
DOI
StatusUdgivet - 1 apr. 2019

ID: 56275277