Trends in HbA1c and other biochemical outcomes of individuals with newly diagnosed type 1 diabetes
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ORIGINAL ARTICLE
Trends in HbA1c and other biochemical outcomes of individuals with newly diagnosed type 1 diabetes A. O’Carroll-Lolait 1 & A. Urwin 2 & I. Doughty 3 & J. Schofield 2 & H Thabit 2,4 & L. Leelarathna 2,4 Received: 5 September 2020 / Accepted: 11 November 2020 # The Author(s) 2020
Abstract Background There is limited data on glycaemic control and cardiovascular risk factor management in newly diagnosed individuals with type 1 diabetes in the first 2 years. Methods Retrospective, single centre study from the North West of England, newly diagnosed with type 1 diabetes between 2014 and 2018 (n = 58). HbA1c, blood pressure, lipids and body mass index (BMI) data were collected from electronic patient records from the time of diagnosis until the end of 2 years, stratified by age 16–24 years or ≥ 25 years at presentation. Results For those aged 16–24 years (n = 31), median (IQR), HbA1c improved at 6 months from 83 (63–93) to 51.5 (46–75) mmol/mol (p = 0.001) and remained stable 6–24 months. For those ≥ 25 years (n = 27), HbA1c declined from 91 (70–107) to 65 (50–89) mmol/mol, (p < 0.01) at 6 months and declined further to 52 mmol/mol (44–70) at 24 months. At 24 months, 27.8% of all individuals had an HbA1c ≥ 69 mmol/mol. Approximately, a third met LDL (< 2 mmol/L) and total cholesterol (< 4 mmol/L) targets. A total of 58.6% of individuals were overweight/obese (BMI > 25 kg/m2) at 24 months compared to 45.8% at baseline. There were no significant blood pressure changes during the follow-up. Conclusions In both age groups, significant improvement of HbA1c occurred within the first 6 months of diagnosis with no statistical difference between the two groups at any of the time points up to 24 months. Despite significant improvements in HbA1c, majority had levels > 53 mmol/mol at 24 months. Alongside the high incidence of obesity and dyslipidaemia, our data support the need for further intensification of therapy from diagnosis of type 1 diabetes. Keywords Cardiovascular risk factors . Complications . HbA1c . Type 1 diabetes
Introduction Diabetes is one of the most common chronic medical conditions in Europe. Relative to the adult population, the incidence of new onset type 1 diabetes (T1DM) is higher in adolescents
* L. Leelarathna [email protected] 1
School of Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
2
Manchester Diabetes Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
3
Royal Manchester Children’s Hospital, Manchester University NHS foundation Trust, Manchester, UK
4
Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
but the prevalence is increasing in all age groups.[1]. The classic symptoms of polydipsia, polyuria, tiredness and weight loss, along with overt hyperglycaemia, are more commonly seen in children, with the presentation in adults often more variable.[2] Great effort is requir
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