Association between early glycemic management and diabetes complications in type 1 diabetes mellitus: A retrospective cohort study |
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| Affiliation: | 1. Section for Pediatric Endocrinology, Cleveland Clinic Children’s, 9500 Euclid Avenue, R Building- R-3, Cleveland, OH 44195, USA;2. University Hospitals Cleveland Medical Center, Rainbow Babies and Children’s Hospital, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106, USA;3. University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106, USA;1. Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;2. Folkhälsan Research Center, Helsinki, Finland;3. Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland;4. Finnish Meteorological Institute, Helsinki, Finland;5. Finnish Institute for Health and Welfare (THL), Helsinki, Finland;6. Karolinska Institute, Stockholm, Sweden;7. Vantaa Health Centre, Vantaa, Finland;8. National University Singapore, Yong Loo Lin School of Medicine, Department of Obstetrics and Gynecology, Singapore, Singapore;9. Singapore Institute for Clinical Sciences (SCIS), Agency for Science, Technology and Research (A?STAR), Singapore;1. Department of Respiratory and Critical Care Medicine, the Center for Biomedical Research, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Sciences and Technology, Wuhan, China;2. Department of Nutrition, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;3. Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, the Third Hospital of Shanxi Medical University, Taiyuan, China;1. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, the United States of America;2. Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, The Ohio State University, Columbus, OH, the United States of America;3. Department of Family and Community Medicine, The Ohio State University, Columbus, OH, the United States of America;4. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, the United States of America;1. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China;2. Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China;3. Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China;1. Social Determinants of Health Research Center, Research Institute for prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran;2. Students’ Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran;3. International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK |
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| Abstract: | AimsTo investigate the association between early HbA1c levels near diagnosis and future glycemic management, and analyzed risk factors of complications in people with T1DM.MethodsThis retrospective cohort study included 201 children and adolescents with T1DM. Patient data including sex, age at diagnosis, duration of disease, HbA1c levels, HbA1c variability during the follow-up period, and diabetes complications and comorbidities were collected.ResultsThe mean follow-up period of patients was 16.4 years. HbA1c levels in all three examined time points after diagnosis (first year, second year, and first two years) were significantly associated with recent HbA1c level, and second-year HbA1c was most closely correlated with recent HbA1c level. Elevated second-year HbA1c was a risk factor of diabetic ketoacidosis (DKA) and retinopathy, and increased variability of HbA1c was significantly related to various microvascular complications. When HbA1c is stratified into quartiles, the subjects of each quartile trend to stay within that quartile over the follow-up period.ConclusionsEarly HbA1c levels were closely associated with recent HbA1c levels and diabetes complications in patients with T1DMs. Strict glucose management after diagnosis and reducing variability of HbA1c may prevent future diabetes complications and comorbidities. |
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| Keywords: | Diabetes mellitus, type 1 Diabetes complications Glycated hemoglobin A Glycemic control |
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