Development of Microvascular Complications and Effect of Concurrent Risk Factors in Type 1 Diabetes: A Multistate Model From an Observational Clinical Cohort Study

• DOI: 10.2337/dc18-0679
• Publication Date: 2018-08-21T17:15:22Z
• Authors: Lasse Bjerg; Adam Hulman; Bendix Carstensen; Morten Charles; Marit E. Jørgensen; Daniel R. Witte
• Keywords: Adult; Male; Diabetic Retinopathy; Models, Statistical; Denmark; Incidence; Middle Aged; 3. Good health; Cohort Studies; 03 medical and health sciences; Diabetes Mellitus, Type 1; 0302 clinical medicine; Diabetic Neuropathies; Cardiovascular Diseases; Risk Factors; Humans; Diabetic Nephropathies; Female; Diabetic Angiopathies; Aged; Glomerular Filtration Rate

OBJECTIVE Type 1 diabetes is a complex disease, and development of multiple complications over time can be analyzed only with advanced statistical methods. This study describes the microvascular explores effect complication burden important concurrent risk factors by applying multistate model. RESEARCH DESIGN AND METHODS We used clinical cohort at Steno Diabetes Center Copenhagen to diabetic kidney retinopathy, neuropathy. extracted information from electronic patient records estimated incidence rates burden. explored extent which modify selected on complications. RESULTS included 3,586 individuals. Incidence rate ratios in individuals two previous were 3.2 (95% CI 2.3–4.5) for 2.1 (1.5–3.1) 1.7 (1.2–2.4) neuropathy compared without The models duration; calendar age as timescales; sex, HbA1c, lipid-lowering antihypertensive treatment, systolic blood pressure, BMI, glomerular filtration (eGFR), cardiovascular disease (CVD), LDL cholesterol, insulin dose (units/kg/day), smoking status covariates. Effects duration, eGFR, cholesterol where not modified burden, whereas sex CVD were. CONCLUSIONS highly depends factor profile type diabetes. results emphasize attention factors, regardless existing number complications, prevent further