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Type 1 diabetes management: Room for improvement
AIMS/HYPOTHESIS: Optimal diabetes care and risk factor management are important to delay micro‐ and macrovascular complications in individuals with type 1 diabetes (T1D). Ongoing improvement of management strategies requires the evaluation of target achievement and identification of risk factors in...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wiley Publishing Asia Pty Ltd
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10036258/ https://www.ncbi.nlm.nih.gov/pubmed/36808864 http://dx.doi.org/10.1111/1753-0407.13368 |
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author | Varkevisser, Rita D. M. Birnie, Erwin Mul, Dick van Dijk, Peter R. Aanstoot, Henk‐Jan Wolffenbuttel, Bruce H. R. van der Klauw, Melanie M. |
author_facet | Varkevisser, Rita D. M. Birnie, Erwin Mul, Dick van Dijk, Peter R. Aanstoot, Henk‐Jan Wolffenbuttel, Bruce H. R. van der Klauw, Melanie M. |
author_sort | Varkevisser, Rita D. M. |
collection | PubMed |
description | AIMS/HYPOTHESIS: Optimal diabetes care and risk factor management are important to delay micro‐ and macrovascular complications in individuals with type 1 diabetes (T1D). Ongoing improvement of management strategies requires the evaluation of target achievement and identification of risk factors in individuals who do (or do not) achieve these targets. METHODS: Cross‐sectional data were collected from adults with T1D visiting six diabetes centers in the Netherlands in 2018. Targets were defined as glycated hemoglobin (HbA1c) <53 mmol/mol, low‐density lipoprotein‐cholesterol (LDL‐c) <2.6 mmoL/L (no cardiovascular disease [CVD] present) or <1.8 mmoL/L (CVD present), or blood pressure (BP) <140/90 mm Hg. Target achievement was compared for individuals with and without CVD. RESULTS: Data from 1737 individuals were included. Mean HbA1c was 63 mmol/mol (7.9%), LDL‐c was 2.67 mmoL/L, and BP 131/76 mm Hg. In individuals with CVD, 24%, 33%, and 46% achieved HbA1c, LDL‐c, and BP targets respectively. In individuals without CVD these percentages were 29%, 54%, and 77%, respectively. Individuals with CVD did not have any significant risk factors for HbA1c, LDL‐c, and BP target achievement. In comparison, individuals without CVD were more likely to achieve glycemic targets if they were men and insulin pump users. Smoking, microvascular complications, and the prescription of lipid‐lowering and antihypertensive medication were negatively associated with glycemic target achievement. No characteristics were associated with LDL‐c target achievement. Microvascular complications and antihypertensive medication prescription were negatively associated with BP target attainment. CONCLUSION: Opportunities for improvement of diabetes management exist for the achievement of glycemic, lipid, and BP targets but may differ between individuals with and without CVD. |
format | Online Article Text |
id | pubmed-10036258 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Wiley Publishing Asia Pty Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-100362582023-03-25 Type 1 diabetes management: Room for improvement Varkevisser, Rita D. M. Birnie, Erwin Mul, Dick van Dijk, Peter R. Aanstoot, Henk‐Jan Wolffenbuttel, Bruce H. R. van der Klauw, Melanie M. J Diabetes Original Articles AIMS/HYPOTHESIS: Optimal diabetes care and risk factor management are important to delay micro‐ and macrovascular complications in individuals with type 1 diabetes (T1D). Ongoing improvement of management strategies requires the evaluation of target achievement and identification of risk factors in individuals who do (or do not) achieve these targets. METHODS: Cross‐sectional data were collected from adults with T1D visiting six diabetes centers in the Netherlands in 2018. Targets were defined as glycated hemoglobin (HbA1c) <53 mmol/mol, low‐density lipoprotein‐cholesterol (LDL‐c) <2.6 mmoL/L (no cardiovascular disease [CVD] present) or <1.8 mmoL/L (CVD present), or blood pressure (BP) <140/90 mm Hg. Target achievement was compared for individuals with and without CVD. RESULTS: Data from 1737 individuals were included. Mean HbA1c was 63 mmol/mol (7.9%), LDL‐c was 2.67 mmoL/L, and BP 131/76 mm Hg. In individuals with CVD, 24%, 33%, and 46% achieved HbA1c, LDL‐c, and BP targets respectively. In individuals without CVD these percentages were 29%, 54%, and 77%, respectively. Individuals with CVD did not have any significant risk factors for HbA1c, LDL‐c, and BP target achievement. In comparison, individuals without CVD were more likely to achieve glycemic targets if they were men and insulin pump users. Smoking, microvascular complications, and the prescription of lipid‐lowering and antihypertensive medication were negatively associated with glycemic target achievement. No characteristics were associated with LDL‐c target achievement. Microvascular complications and antihypertensive medication prescription were negatively associated with BP target attainment. CONCLUSION: Opportunities for improvement of diabetes management exist for the achievement of glycemic, lipid, and BP targets but may differ between individuals with and without CVD. Wiley Publishing Asia Pty Ltd 2023-02-17 /pmc/articles/PMC10036258/ /pubmed/36808864 http://dx.doi.org/10.1111/1753-0407.13368 Text en © 2023 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Varkevisser, Rita D. M. Birnie, Erwin Mul, Dick van Dijk, Peter R. Aanstoot, Henk‐Jan Wolffenbuttel, Bruce H. R. van der Klauw, Melanie M. Type 1 diabetes management: Room for improvement |
title | Type 1 diabetes management: Room for improvement |
title_full | Type 1 diabetes management: Room for improvement |
title_fullStr | Type 1 diabetes management: Room for improvement |
title_full_unstemmed | Type 1 diabetes management: Room for improvement |
title_short | Type 1 diabetes management: Room for improvement |
title_sort | type 1 diabetes management: room for improvement |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10036258/ https://www.ncbi.nlm.nih.gov/pubmed/36808864 http://dx.doi.org/10.1111/1753-0407.13368 |
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