Characteristics of newly diagnosed adults with type 1 diabetes in the UK and evolution of glycaemic control, body mass index and Charlson comorbidity index over the first 5 years after diagnosis.
AIMS: This retrospective, longitudinal study characterised 2430 adults (mean age 40.8+/-16.1years) with newly diagnosed type 1 diabetes (T1D) over the first 5years of insulin treatment.
METHODS: Data from 1year pre- and up to 5 years post-insulin initiation were extracted from the UK Clinical Practice Research Datalink (1990-2013). Baseline HbA1c, BMI and Charlson comorbidity index (CCI) score were compared with data at 1, 2, 3 and 5 years.
RESULTS: Mean HbA1c decreased significantly from baseline 95+/-32.8mmol/mol (10.8+/-3.0%) to 61+/-21.9mmol/mol (7.7+/-2.0%) at 1year, remaining significantly lower at 2, 3 and 5 years (p<0.0001). One year after initiating insulin, only 6.3% of patients had HbA1c <48mmol/mol (<6.5%). There was no further improvement in HbA1c after 1year. Mean BMI increased significantly from baseline 25.3+/-5.5kg/m(2) to 27.2+/-5.8kg/m(2) at 1year; p<0.0001), remaining significantly higher thereafter, with over two-thirds having overweight/obesity by year 5. Mean CCI score increased significantly (1.32, baseline; 1.46, year 1; 1.75, year 5). CCI patterns were similar within BMI and HbA1c strata.
CONCLUSIONS: More intensive support to reach and maintain glycaemic targets soon post-diagnosis, while avoiding weight gain, and prevention and optimal management of comorbidities are warranted.
|ジャーナル名||Primary care diabetes|
|投稿者||Ramtoola, Shenaz; Nyeland, Martin Erik; Jacobsen, Judith; Ploug, Uffe Jon; Kragh, Nana; Zimmermann, Esther|
|組織名||Department of Diabetes, Royal Blackburn Hospital, Blackburn, United Kingdom.;Electronic address: Shenaz.Ramtoola@elht.nhs.uk.;Novo Nordisk A/S, Copenhagen, Denmark.;Statcon ApS, Kokkedal, Denmark.|