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Prim Care Diabetes. 2019 Oct 25. pii: S1751-9918(19)30290-6. doi: 10.1016/j.pcd.2019.09.009. [Epub ahead of print]

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.

Author information

1
Department of Diabetes, Royal Blackburn Hospital, Blackburn, United Kingdom. Electronic address: Shenaz.Ramtoola@elht.nhs.uk.
2
Novo Nordisk A/S, Copenhagen, Denmark.
3
Statcon ApS, Kokkedal, Denmark.

Abstract

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/m2 to 27.2±5.8kg/m2 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.

KEYWORDS:

Adult-onset; CPRD; Comorbidity; Insulin; Obesity; Overweight; Type 1 diabetes

PMID:
31668975
DOI:
10.1016/j.pcd.2019.09.009
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