Metabolic health in people living with type 1 diabetes in Belgium: a repeated cross-sectional study
Authors' conclusion
Overweight, obesity and combined metabolic abnormalities are increasingly being identified in people living with type 1 diabetes, further accelerating the risk of microvascular and macrovascular complications. Early identification of the presence of combined metabolic abnormalities should enable therapeutic interventions to be modified towards multifactorial approaches, with attention to education on avoidance of overweight (e.g. dietary counselling) in addition to strict glycaemic control and intensification of use of antihypertensive agents and statins. Use of adjunct therapies in this population as a tool should be explored more thoroughly to reduce risk of complications.
Study context
- Population
- Adults (≥16 years) with T1D diagnosed at age ≤45 years, diabetes duration ≥1 year, on intensive insulin therapy, Belgium, 2001–2022
- Participants
- 26,791 registrations
- Exposure
- 2001/2005 vs 2022; with vs without combined metabolic abnormalities
- Outcome
- Evolution of treatment and metabolic health, incl. prevalence of obesity and combined metabolic abnormalities
- Follow-up
- 2001–2022
Methodological detailsreal-world, registry data from all 101 Belgian diabetes clinics
- Real-world
- Registry data from all 101 Belgian diabetes clinics
Main finding
As reported in the abstract
- Obesity, 2001 vs 2022
- 12.1% vs 21.7%, p<0.0001
- WHO criteria, women, 2001 vs 2022
- 26.9% vs 42.9%, p<0.0001
- WHO criteria, men, 2001 vs 2022
- 30.4% vs 52.1%, p<0.0001
- WHO criteria without albuminuria, women, 2001 vs 2022
- 22.3% vs 40.6%, p<0.0001
- WHO criteria without albuminuria, men, 2001 vs 2022
- 25.1% vs 49.2%, p<0.0001
- NCEP-ATPIII criteria, women, 2005 vs 2022
- 39.9% vs 57.2%, p<0.0001
- NCEP-ATPIII criteria, men, 2005 vs 2022
- 40.8% vs 60.9%, p<0.0001
- IDF criteria, women, 2005 vs 2022
- 43.9% vs 59.3%, p<0.001
- IDF criteria, men, 2005 vs 2022
- 33.7% vs 50.0%, p<0.0001
Observational data: associations, not effects.
Further findings
HbA1c >58 mmol, with vs without combined metabolic abnormalities · 2022
- Men, with vs without
- 48.9% vs 36.9%
- Women, with vs without
- 53.3% vs 41.1%, p<0.0001
Adjunct therapy use · 2022
- More often treated with metformin, SGLT2i and GLP-1 RA with combined metabolic abnormalities
Complications · 2022
- Combined metabolic abnormalities strongly related to eye complications, peripheral neuropathy, CKD and CVD in men and women
- Corrected for age, diabetes duration and HbA1c
Original publication
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