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Diabetes Res Clin Pract. 2016 Dec;122:28-37. doi: 10.1016/j.diabres.2016.09.024. Epub 2016 Oct 4.

Type 1 diabetes in older adults: Comparing treatments and chronic complications in the United States T1D Exchange and the German/Austrian DPV registries.

Author information

1
SUNY Upstate Medical University, Syracuse, NY, USA.
2
Hospital Hietzing, 3rd Medical Department, Vienna, Austria.
3
Jaeb Center for Health Research, Tampa, FL, USA. Electronic address: T1DStats@jaeb.org.
4
University of Ulm, ZIBMT, Institute of Epidemiology and Medical Biometry, Ulm, Germany; German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany.
5
Stanford University, Palo Alto, CA, USA.
6
Medical University of Lübeck, Department of Internal Medicine, Lübeck, Germany.
7
University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
8
Medical University of Innsbruck, Department of Pediatrics, Innsbruck, Austria.
9
Jaeb Center for Health Research, Tampa, FL, USA.

Abstract

AIMS:

Compare characteristics, therapies and clinical outcomes in older adults with type 1 diabetes in the United States T1D Exchange (T1DX) and German/Austrian Diabetes Patienten Verlaufsdokumentation (DPV) registries.

METHODS:

Cross-sectional study of adults ≥60years old with type 1 diabetes seen in 2011-2012 in the T1DX (n=1283) and DPV (n=2014) registries. Wilcoxon rank-sum test was used for continuous variables and chi-square test for categorical variables. Adjusted analyses used generalized linear models.

RESULTS:

Individuals in both registries were similar in body mass index (mean 27kg/m2), percent with obesity (25%) and gender (48% male). In T1DX there was longer diabetes duration (32.3 vs. 28.8years), greater use of antihypertensive medications (including ACE-I and ARBs; 85% vs. 62%), statins (68% vs. 40%), aspirin (77% vs. 21%), insulin pumps (58% vs. 18%), and less smoking (7% vs. 10%); lower adjusted mean LDL-cholesterol (84 vs. 109mg/dL), and lower adjusted mean systolic and diastolic blood pressures (128 vs. 136 and 68 vs. 74mmHg); fewer myocardial infarctions (6% vs. 9% [99% CI of difference, 1% to 5%]), strokes (2% vs. 8% [3% to 7%]), microvascular complications including microalbuminuria (17% vs. 44% [22% to 32%]) but increased depression (16.1% vs. 8.7%). Adjusted mean HbA1c levels were similar (7.5%, 58mmol/mol).

CONCLUSIONS:

Differences between the registries included greater use of antihypertensives, statins and insulin pumps, and fewer chronic complications in the T1DX. Further research is needed to better understand the role of intensive therapy in improving outcomes in older adults with type 1 diabetes.

KEYWORDS:

DPV; Geriatrics; T1D Diabetes Exchange; Type 1 diabetes

PMID:
27764721
DOI:
10.1016/j.diabres.2016.09.024
[Indexed for MEDLINE]

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