This epidemiological analysis of the pooled Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) cohort describes the equivalence of a 1-percentage point increase in HbA (such as from 7% to 8%) and years of additional age or duration of type 1 diabetes (T1D) relative to the risk of complications. Separate Cox proportional hazards models determined the number of additional years of age and/or duration of T1D that would result in the same increase in risk of microvascular (retinopathy, nephropathy, and neuropathy) and cardiovascular complications and mortality as a 1-percentage point increase in HbA . The risk of any cardiovascular disease associated with a 1-percentage point increase in HbA was equivalent to the risk associated with 4.3 (95% CI 2.7-5.9) additional years of age or 5.6 (95% CI 2.7-6.5) additional years' duration of T1D. The risk of estimated glomerular filtration rate <60 mL/min/1.73 m and/or end-stage renal disease associated with a 1-percentage point increase in HbA was equivalent to the risk associated with 12.1 (95% CI 8.3-15.9) additional years of age or 18.0 (95% CI 4.3-31.7) additional years' duration of T1D. The proliferative diabetic retinopathy risk associated with a 1-percentage point increase in HbA was equivalent to the risk associated with 6.4 (95% CI 5.3-7.4) additional years' duration of T1D, while for mortality risk, it was equivalent to the risk associated with 12.9 (95% CI 6.6-19.3) additional years of age. Our results help evaluate the impact of glycemia on advanced complications in a way that may be more interpretable to health care providers and individuals with T1D.
Reference Type
Journal Article
Periodical Full
Diabetes care
Publication Year
2020
Publication Date
Oct
Volume
43
Issue
10
Start Page
2478
Other Pages
2484
Publisher
American Diabetes Association
Place of Publication
United States
ISSN/ISBN
0149-5992
Document Object Index
10.2337/dc20-0226
URL
https://www.ncbi.nlm.nih.gov/pubmed/32788280 https://www.ncbi.nlm.nih.gov/pubmed/32788280