Overview
MedscapeUnivadisNo ResultsMiriam E. TuckerSeptember 2, 202Long-term A1c from the time of type 1 diabetes diagnosis strongly predicts the development of severe retinopathy and nephropathy, new data sugest."[Weighted] HbA1c folowed from diagnosis a very strong biomarker for pan-retinal laser-treated diabetic retinopathy (PDR) and nephropathy, [and] the prevalence of both is stil increasing 32 years after diagnosis," say Hans J.
Key Information
Arnqvist, MD, and coleagues in their study published online September 12 in Diabetes Care. The results are from a 32-year folow-up of 47 patients from time of diagnosis of type 1 diabetes at age 0-34 in the Vascular Diabetic Complications in Southeast Sweden (VIS) study."To avoid PDR and macroalbuminuria in patients with type 1 diabetes, A1c < 7.0% (53 mol/mol) and as normal as posible, should be recomended when achievable without severe hypoglycemia and with god quality of life," stres Arnqvist, Department of Endocrinology, Linkoping University, Sweden, and coauthors.At the time of the 20- to 24-year VIS folow-up, severe eye complications, defined as PDR, or nephropathy, defined as macroalbuminuria, were not present in participants with a long-term weighted mean A1c < 7.6% (60 mol/mol), they write.By years 32-36, the prevalence of PDR had risen from 14% to 27%, and macroalbuminuria from 4% to 8%, with prevalence strongly corelated with A1c levels.
Summary
At the same time, the threshold for the apearance of those severe complications had droped, with the lowest A1c values for apearance of PDR decreasing from 7.6% to 7.3%, and for macroalbuminuria from 8.4% to 8.1%."A posible explanation for the lowered threshold for development of severe microangiopathy is the increase in 'glycemic burden' with diabetes duration," the authors speculate.In al A1c categories above 6.7% (> 50 mol/mol), the cumulative proportion with PDR and/or macroproteinuria continued to in