Estimated glucose disposal rate is associated with retinopathy and kidney disease in young people with type 1 diabetes: a nationwide observational study
Authors' conclusion
eGDR, a proxy for insulin resistance, is associated with retinopathy and kidney disease in young adults with T1D. The risk of retinopathy increased with lower eGDR. The risk of kidney disease also increased with lower eGDR; however results show no association between the lowest eGDR and kidney disease. eGDR can be helpful to identify young T1D individuals at risk.
Study context
- Population
- Children and adults with T1D duration <10 years, 1998–2017, Swedish registries (SweDiabKids, NDR); median age 21 years, 42% female
- Participants
- 22,146 children2 overlapping cohorts
- Exposure
- Estimated glucose disposal rate (eGDR) categories <4, 4 to 5.99, 6 to 7.99 vs ≥8 mg/kg/min
- Outcome
- Retinopathy or kidney disease (micro- or macroalbuminuria)
- Follow-up
- Median 4.8 years (IQR 2.6-7.7)
Methodological detailsobservational, multivariable Cox regression
- Observational
- Multivariable Cox regression
Main finding
As reported in the abstract
Retinopathy · median follow-up 4.8 years
Each group vs eGDR ≥ 8Adjusted hazard ratio (95% CI)
eGDR 7.99 to 6
1.29(1.20–1.40)
eGDR 5.99 to 4
1.50(1.31–1.71)
eGDR < 4
1.74(1.41–2.14)
Observational data: associations, not effects.
Further findings
| Outcome | eGDR ≥ 8 | eGDR 7.99 to 6 | eGDR 5.99 to 4 | eGDR < 4 | aHR (95% CI) | |
|---|---|---|---|---|---|---|
| Kidney disease (micro- or macroalbuminuria) · median follow-up 4.8 yearseGDR 7.99 to 6vs eGDR ≥ 8 | 6.5% | 13.3% | 26.8% | 46.6% | 1.30 (1.11–1.52) | |
| Kidney disease (micro- or macroalbuminuria) · median follow-up 4.8 yearseGDR 5.99 to 4vs eGDR ≥ 8 | 1.58 (1.25–1.99) | |||||
| Kidney disease (micro- or macroalbuminuria) · median follow-up 4.8 yearseGDR < 4vs eGDR ≥ 8 | 1.33 (0.95–1.86) | |||||
| 0.512Adjusted hazard ratio (log scale) |
- Kidney disease (micro- or macroalbuminuria): kidney disease cohort n=11 857
Original publication
Estimated glucose disposal rate is associated with retinopathy and kidney disease in young people with type 1 diabetes: a nationwide observational study. Cardiovasc Diabetol. Published 19 March 2023. doi:10.
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