Frailty outperforms conventional risk factors for predicting complications and death in type 1 diabetes
Authors' conclusion
Frailty is common in type 1 diabetes and independently predicts earlier and higher risk of complications and death. Routine assessment may improve risk stratification and support individualized care.
Study context
- Population
- Adults with T1D from the nationwide FinnDiane cohort, aged 18–81 years at baseline
- Participants
- 4,819 adults
- Exposure
- Frail and pre-frail vs non-frail
- Outcome
- Major cardiovascular events, kidney replacement therapy, severe retinopathy, and all-cause and cause-specific mortality
- Follow-up
- Median 19 years
Methodological detailsnationwide, registry follow-up, Cox and Fine-Gray models; Weibull models for earlier onset
- Nationwide
- Registry follow-up
- Cox and Fine-Gray models; Weibull models for earlier onset
Main finding
As reported in the abstract
- Frail vs non-frail: higher hazards of complications
- 3- to 118-fold
- Frail vs non-frail: onset of complications accelerated by
- 2-6 years
- Frailty: higher risk of all-cause mortality
- tenfold
- Frailty: reduced survival by
- 4.5 years
Observational data: associations, not effects.
Further findings
Discrimination (10-year time-dependent AUC)
- Discrimination was good to excellent and outperformed individual conventional risk factors
Original publication
Frailty outperforms conventional risk factors for predicting complications and death in type 1 diabetes. Diabetes Res Clin Pract. Published 13 November 2025. doi:10.
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