Early increase in HbA1c trajectory predicts development of severe microangiopathy in patients with type 1 diabetes: the VISS study
Authors' conclusion
The HbA1c trajectory from diabetes onset shows that mean HbA1c for the period 5-8 years after diagnosis strongly predicts severe microangiopathy. Females with childhood-onset diabetes exhibit a high peak in HbA1c during adolescence associated with higher wHbA1c and a higher prevalence of PDR.
Study context
- Population
- Patients diagnosed with T1D before 35 years of age, 1983–1987, followed from diagnosis until 2019 (VISS study)
- Participants
- 447 patients
- Outcome
- Severe diabetic microangiopathy: proliferative diabetic retinopathy (PDR) or macroalbuminuria (nephropathy)
- Follow-up
- 32 years
Main finding
As reported in the abstract
Severe microangiopathy
Developed proliferative diabetic retinopathy (PDR)
27%
Developed macroalbuminuria
8%
Observational data: associations, not effects.
Further findings
HbA1c trajectories
- Trajectories for patients developing PDR and macroalbuminuria follow separate courses early and stay separated for 32 years
- Without severe complications: initial dip, then slow HbA1c increase; with severe complications: HbA1c rises directly to a high level within a few years
Females with childhood-onset diabetes
- High HbA1c peak during adolescence, associated with higher weighted HbA1c and higher prevalence of PDR
Original publication
Early increase in HbA1c trajectory predicts development of severe microangiopathy in patients with type 1 diabetes: the VISS study. BMJ Open Diabetes Res Care. Published 6 May 2024. doi:10.
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