A 20-year prospective follow-up study to evaluate the development of retinopathy and nephropathy after the onset of type 1 diabetes mellitus: Contribution of glycemic control and metabolic memory

Abstract

The 20-year clinical follow-up of patients who had fallen ill with T1DM in childhood showed that diabetic microangiopathies developed with the long-term preservation of poor blood glucose control (BGC) starting at the onset of the disease. At the same time, the complications progressed to more severe stages, despite a clear trend toward better BGC. This may be suggestive of the negative metabolic memory phenomenon, which necessitates stable BGC, starting at the onset of the disease, for the prevention of microvascular complications.

Association of diabetic ketoacidosis and HbA1c at onset with year‐three HbA1c in children and adolescents with type 1 diabetes: Data from the International SWEET Registry

“…The importance of HbA1c at disease onset is not well‐known and current studies either include few patients or have short follow‐up time and none is based on multicenter, international data. Some authors highlighted the role of metabolic memory, suggesting that pre‐diagnosis exposure to elevated glucose levels has a bearing on subsequent outcome . Future research is needed to establish why children with high HbA1c values at diagnosis continue to have worse metabolic control and if this is related to pathophysiological or genetic issues.…”

Bilateral cataracts as the first manifestation of type 1 diabetes mellitus

“…Type 1 diabetes mellitus commonly occurs in children and adolescents and is associated with chronic medical complications gravely affecting vision and kidney function, such as retinopathy and nephropathy, respectively. [ 1 ] However, these complications rarely occur at an early age. Cataracts have been linked to several factors, including aging, genetics, local nutritional disorders, immune and metabolic abnormalities, trauma, poisoning, and radiation exposure.…”

The Prevalence of Associated Autoimmune Diseases Among Adults With Type 1 Diabetes Mellitus: A Cross-Sectional Study

“…Similarly, macroalbuminuria was detected in 159 participants; they were subsequently followed up for a median duration of nine years [ 25 ]. In addition, around half of the participants underwent an ophthalmologic examination, and diabetic retinopathy was found in a third of them, which was considered lower than that reported internationally [ 23 ].…”

“…In a study investigating diabetic microvascular complications during a 20-year follow-up period after the onset of T1DM (155 participants fully completed the follow-up duration), nephropathy and retinopathy were observed in 24 (15.5%) and 86 (55.5%) cases, respectively [ 23 ]. ACR was collected in most of our patients (~80%), which is considered an acceptable practice.…”