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The Capital Region of Denmark - a part of Copenhagen University Hospital
In preparation

Influence of improved metabolic control on cardiovascular risk in children with type 1 diabetes

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Background
Type 1 Diabetes (T1D) is a serious disease with a substantial increased morbidity and mortality primarily due to cardiovascular death. Late complications including mortality are associated with higher HbA1c levels. Optimizing metabolic control to lower HbA1c often improves hyperlipidemia, which favors cardiovascular health however, lowering HbA1c levels may also lead to increased body mass index (BMI) with a possible negative effect on cardiovascular health. During the last two decades focus has mainly been on optimizing HbA1c and avoiding severe hypoglycemic events, which has been successful. While some attention has been on BMI, little attention has been on the balance between the three, and a question is to what extent lower HbA1c levels affect BMI. The primary aim is to examine the association between HbA1c and BMI in a national childhood T1D population.
Methods
Based on the nationwide population-based Danish Childhood Diabetes register (DanDiabKids) which includes annual registration of clinical and treatment information, we aim to investigate the association between levels of HbA1c and BMI z-scores with adjustment for age, gender, disease duration, puberty and calendar time using mixed linear regression models.
Results
Between 2000 and 2017, 6,616 children with T1D under age 18 years with visits in the clinic were identified from DanDiabKids. Out of these, 53% were boys and 75% of the children had disease onset between age 5 and 14. Mean of HbA1c levels was 66 mmol/mol (interquartile range: 57; 74) and mean of BMI z-scores was 0.6 (interquartile range: -0.1; 1.2). Overall, 19% had ever had a severe hypoglycemic event during their treatment period. There was a small but negative association between HbA1c levels and BMI z-scores after adjustment for co-factors, estimate= -0.004 (95% CI -0.005; ¬-0.004).
Conclusion
From preliminary results there is a tendency to a slightly increase in BMI with lower HbA1c levels. Further spline regression analyses are required to make final conclusions about the exact association.
Original languageDanish
Publication date2019
Publication statusIn preparation - 2019
EventEuropean Diabetes Epidemiology Group, EDEG 2019 - , Luxembourg
Duration: 11 May 201914 May 2019

Conference

ConferenceEuropean Diabetes Epidemiology Group, EDEG 2019
CountryLuxembourg
Period11/05/201914/05/2019

Event

European Diabetes Epidemiology Group, EDEG 2019

11/05/201914/05/2019

Luxembourg

Event: Conference

ID: 56850582