Achievement of treatment targets predicts progression of vascular complications in type 1 diabetes

Salna, Ilze; Salna, Edgars; Pahirko, Leonora; Skrebinska, Sabīne; Krikova, Regīna; Folkmane, Inese; Pīrāgs, Valdis; Sokolovska, Jeļizaveta

doi:10.1016/j.jdiacomp.2021.108072

Cited by 5 publications

(8 citation statements)

References 37 publications

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“…Additionally, they could learn about the study from posts in the closed Facebook group “Diabetes in Latvia”. We also identified potential study participants using metadata from the longitudinal study “LatDiane: Latvian diabetic nephropathy study”, initiated in 2013 [ 21 ]. Currently, more than 355 well-characterized patients with Type 1 diabetes are in the LatDiane study.…”

Section: Methodsmentioning

confidence: 99%

Quantitative and qualitative analysis of the quality of life of Type 1 diabetes patients using insulin pumps and of those receiving multiple daily insulin injections

Tzivian

Sokolovska

Grike

et al. 2022

Health Qual Life Outcomes

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Introduction Insulin pump therapy represents an alternative to multiple daily injections and can improve glycemic control and quality of life (QoL) in Type 1 diabetes mellitus (T1DM) patients. We aimed to explore the differences and factors related to the T1DM-specific QoL of such patients in Latvia. Design and methods A mixed-method cross-sectional study on 87 adult T1DM patients included 20 pump users and 67 users of injections who participated in the quantitative part of the study; 8 pump users and 13 injection users participated in the qualitative part. Patients were invited to participate using a dedicated digital platform. Their QoL and self-management habits were assessed using specially developed questionnaires adapted to Latvian conditions. Multiple logistic regression models were built to investigate the association between social and self-management factors and patients’ QoL. In addition, qualitative analysis of answers was performed. Results Insulin pump users were younger, had higher incomes, and reported higher T1DM expenses than users of multiple daily injections. There were no differences in self-management between the groups; Total QoL differed at the 0.1 significance level. In fully adjusted multiple logistic regression models, the most important factor that increased Total QoL was lower T1DM-related expenses (odds ratio, OR 7.02 [95% confidence interval 1.29; 38.0]). Men and those with more years of living with T1DM had better QoL (OR 9.62 [2.20; 42.1] and OR 1.16 [1.05; 1.29], respectively), but the method of administration was not significantly associated with QoL (OR 7.38 [0.87; 62.9]). Qualitative data supported the results of quantitative analysis. Conclusions QoL was the main reason to use an insulin pump, while the expense was the main reason to avoid the use of it or to stop using it. Reimbursement policies thus should be considered to enable patients to choose the more convenient method for themselves.

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Section: Methodsmentioning

confidence: 99%

Quantitative and qualitative analysis of the quality of life of Type 1 diabetes patients using insulin pumps and of those receiving multiple daily insulin injections

Tzivian

Sokolovska

Grike

et al. 2022

Health Qual Life Outcomes

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“…Moreover, dyslipidemia and hypertension have been hypothesized to have synergistic effects in cardiovascular risk 5 . Lowering blood pressure, and to a lesser extent low‐density lipoprotein‐cholesterol (LDL‐c), has been shown to have protective effects against CVD in individuals with T1D 6,7 …”

Section: Introductionmentioning

confidence: 99%

“…Despite the large burden of CVD in individuals with T1D, reports on the achievement of LDL‐c and blood pressure targets are limited. In addition, percentages of individuals with T1D reaching treatment targets 6,8 in glycated hemoglobin (HbA1c), lipid, and blood pressure achievement vary from 10%–39%, 24%–73%, to 62%–84%, respectively 6,9 . Importantly, assessing the subgroup of individuals with T1D who already experienced a cardiovascular event is particularly relevant, as these individuals are still at (high) risk for recurrent CVD 10 .…”

Section: Introductionmentioning

confidence: 99%

“…5 Lowering blood pressure, and to a lesser extent low-density lipoprotein-cholesterol (LDL-c), has been shown to have protective effects against CVD in individuals with T1D. 6,7 Assessing whether individuals are reaching treatment goals and identifying subgroup differences in reaching these targets is necessary to improve patient care and self-management. Despite the large burden of CVD in individuals with T1D, reports on the achievement of LDL-c and blood pressure targets are limited.…”

mentioning

confidence: 99%

“…In addition, percentages of individuals with T1D reaching treatment targets 6,8 in glycated hemoglobin (HbA1c), lipid, and blood pressure achievement vary from 10%-39%, 24%-73%, to 62%-84%, respectively. 6,9 Importantly, assessing the subgroup of individuals with T1D who already experienced a cardiovascular event is particularly relevant, as these individuals are still at (high) risk for recurrent CVD. 10 Data on target achievement in this group are extremely limited.…”

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confidence: 99%

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Type 1 diabetes management: Room for improvement

Varkevisser

Birnie

Mul³

et al. 2023

Journal of Diabetes

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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.

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Prediction of type 1 diabetes with machine learning algorithms based on FTIR spectral data in peripheral blood mononuclear cells

Rostoka,

Shvirksts,

Salna

et al. 2023

Anal. Methods

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Achievement of treatment targets predicts progression of vascular complications in type 1 diabetes

Cited by 5 publications

References 37 publications

Quantitative and qualitative analysis of the quality of life of Type 1 diabetes patients using insulin pumps and of those receiving multiple daily insulin injections

Quantitative and qualitative analysis of the quality of life of Type 1 diabetes patients using insulin pumps and of those receiving multiple daily insulin injections

Type 1 diabetes management: Room for improvement

Prediction of type 1 diabetes with machine learning algorithms based on FTIR spectral data in peripheral blood mononuclear cells

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