Impact of HbA1c, Followed From Onset of Type 1 Diabetes, on the Development of Severe Retinopathy and Nephropathy: The VISS Study (Vascular Diabetic Complications in Southeast Sweden)

Nordwall, Maria; Abrahamsson, Mariann; Dhir, Meryl; Fredrikson, Mats; Ludvigsson, Johnny; Arnqvist, Hans J.

doi:10.2337/dc14-1203

Cited by 133 publications

(102 citation statements)

References 38 publications

(26 reference statements)

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“…Vascular Diabetic Complications in Southeast Sweden (VISS) study reported similar findings [21]. The VISS study a longitudinal observational study of 451 patients with diabetes who were followed for up to 24 years found that keeping HBA1c below 7.6% was beneficial in preventing retinopathy and persistent microalbuminuria for up to 20 years [21]. Intensive blood pressure control in patients with type 2 diabetes reduced the incidence and progression of diabetic neuropathy over 4-5 years follow up similar to the results in our study.…”

Section: Discussionsupporting

confidence: 72%

“…Hyperglycaemia and hypertension are the main risk factors of developing retinopathy in patients with diabetes as also seen with our study [20]. Vascular Diabetic Complications in Southeast Sweden (VISS) study reported similar findings [21]. The VISS study a longitudinal observational study of 451 patients with diabetes who were followed for up to 24 years found that keeping HBA1c below 7.6% was beneficial in preventing retinopathy and persistent microalbuminuria for up to 20 years [21].…”

Section: Discussionsupporting

confidence: 66%

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Correlation of duration, hypertension and glycemic control with microvascular complications of diabetes mellitus at a tertiary care hospital

Ramanathan¹

2017

Integr Mol Med

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Aim: To evaluate microvascular complications in Diabetes Mellitus (DM) and to study correlation of Microvascular Complication with duration of diabetes, glycemic control and hypertension in a tertiary care centre. Though the study is not uncommon there are very few published reports on correlation of all three factors (together in the same study) with microvascular complications of diabetes mellitus. Materials and methods:Design: Retrospective, observational study. The study has been done through 2007 to 2009 in general hospital, Ahmedabad, India and comprises of 500 patients with Diabetes Mellitus with detailed history, physical examination and laboratory investigations including vibration perception test/ electromyography/nerve conduction velocity, fundus examination and urine for microalbuminuria/urine for protein.Results: Diabetic Retinopathy was the most common complication observed in the present study with prevalence of 42% (210/500) followed by Diabetic Neuropathy with a prevalence of 38% (190/500) and Diabetic Nephropathy with a prevalence of 35% (175/500). Diabetic Retinopathy, Neuropathy and Nephropathy all were associated with poor glycemic control. 190/210 (90%) patients of Diabetic Retinopathy, 175/190 (92%) patients of Diabetic Neuropathy and all 175 patients of Diabetic Nephropathy had associated hypertension. 85/210 (40%) patients of Diabetic Retinopathy had duration between 10-15 years, 115/210 (55%) patients of Diabetic Retinopathy had a duration of >15 years, 70/190 (37%) patients of Diabetic Neuropathy had duration of DM 10-15 years and 70/190 (37%) patients had duration of DM >15years. 95/175 (54%) patients of Diabetic Nephropathy had a duration of DM >15 years. 70% diabetic patients with no microvascular complications had duration of diabetes <5 years while 83% diabetic patients with no microvascular complications had HbA1c < 7.0%. Conclusion:In our experience, long duration of Diabetes, poor glycemic control and associated hypertension all increased the chances of microvascular complications of diabetes.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionsupporting

confidence: 66%

Correlation of duration, hypertension and glycemic control with microvascular complications of diabetes mellitus at a tertiary care hospital

Ramanathan¹

2017

Integr Mol Med

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“…Despite advances in insulin formulation and delivery, patients with type 1 diabetes often fail to reach the target HbA1c of <7% 1, 4. Inadequate glucose control can lead to acute conditions such as ketoacidosis 5, and to chronic complications including retinopathy, nephropathy and cardiovascular disease 6, 7, 8. Compared with the general population, the risk of cardiovascular disease is nearly eight times greater in patients with type 1 diabetes 7, and the increased risk of mortality from heart disease is even greater 9.…”

Section: Introductionmentioning

confidence: 99%

Empagliflozin as adjunct to insulin in patients with type 1 diabetes: a 4‐week, randomized, placebo‐controlled trial (EASE‐1)

Pieber

Famulla

Eilbracht

et al. 2015

Diabetes Obesity Metabolism

158

165

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AimsTo investigate the pharmacodynamics, efficacy and safety of empagliflozin as adjunct to insulin in patients with type 1 diabetes.MethodsA total of 75 patients with glycated haemoglobin (HbA1c) concentrations of ≥7.5 to ≤10.5% (≥58 to ≤91 mmol/mol) were randomized to receive once‐daily empagliflozin 2.5 mg, empagliflozin 10 mg, empagliflozin 25 mg, or placebo as adjunct to insulin for 28 days. Insulin dose was to be kept as stable as possible for 7 days then adjusted, at the investigator's discretion, to achieve optimum glycaemic control. The primary exploratory endpoint was change from baseline in 24‐h urinary glucose excretion (UGE) on day 7.ResultsEmpagliflozin significantly increased 24‐h UGE versus placebo on days 7 and 28. On day 28, adjusted mean differences with empagliflozin versus placebo in changes from baseline in: HbA1c were −0.35 to −0.49% (−3.8 to −5.4 mmol/mol; all p < 0.05 vs. placebo); total daily insulin dose −0.07 to −0.09 U/kg (all p<0.05 vs placebo); and weight were −1.5 to −1.9 kg (all p < 0.001 vs. placebo). In the placebo, empagliflozin 2.5, 10 and 25 mg groups, respectively, adverse events were reported in 94.7, 89.5, 78.9 and 100.0% of patients, and the rate of symptomatic hypoglycaemic episodes with glucose ≤3.0 mmol/l not requiring assistance was 1.0, 0.4, 0.5 and 0.8 episodes per 30 days.ConclusionsIn patients with type 1 diabetes, empagliflozin for 28 days as adjunct to insulin increased UGE, improved HbA1c and reduced weight with lower insulin doses compared with placebo and without increasing hypoglycaemia.

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“…Segundo Nathan et al 20 valores de HbA1c acima de 10,4% estão associadas a um aumento de sete vezes o risco de morte devido a complicações cardiovasculares. Um estudo recente demonstrou que valores de HbA1c menores que 7,6% esta associada a uma prevenção do desenvolvimento de complicações microvasculares por no mínimo 20 anos 21 . Há uma correlação direta forte entre os níveis de glicose pré-exercício e pós-exercício (r=0,851, p=0,002).…”

Section: Discussionunclassified

Efeito Agudo Dos Exercícios Intermitentes Sobre a Glicemia De Adolescentes Com Diabetes Tipo 1

Lima

Mascarenhas

Decimo

et al. 2017

Rev Bras Med Esporte

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Artigo originAl Original article artículO Original RESUMOIntrodução: O exercício físico é um fator importante do tratamento do diabetes mellitus. Objetivo: Verificar o efeito agudo dos exercícios intermitentes sobre glicemia e oxidação de substratos energéticos em adolescentes com diabetes tipo 1. Métodos: Foram avaliados 10 adolescentes diabéticos com idade entre 10 e 15 anos. Foram avaliadas as medidas antropométricas, hemoglobina glicosilada (HbA1c), VO 2máx e o teste de exercício intermitente. Nesse teste, os indivíduos permaneceram pedalando por 30 minutos em cicloergômetro com carga de 60% do VO 2máx , intercalados com tiros de intensidades máximas de 10 segundos a cada 5 minutos. Os substratos energéticos foram avaliados durante o teste e a glicemia capilar foi medida antes, imediatamente após o exercício e 30 minutos depois. Foi observada redução média da glicemia de 39,2 ± 41,92 mg/dl, isto é, média de 21,61% da glicemia inicial. Ocorreu diferença significativa (0,0001) entre os substratos energéticos oxidados, com predominância da utilização de CHO. Há uma forte correlação direta entre a HbA1c e o escore z do IMC (r = 0,821, p = 0,004) e entre HbA1c e glicose observadas pós-exercício (r = 0,702, p = 0,024) e também há forte correlação entre os níveis de glicose pré-exercício e pós-exercício (r = 0,851, p = 0,002) e entre pós-exercício e 30 minutos depois do exercício (r = 0,874, p = 0,001). O teste de regressão linear mostrou que o escore z do IMC explica 67% dos valores de HbA1c (r² = 0,675). Resultados: De acordo com os resultados observados, 30 minutos de exercícios aeróbicos intermitentes intercalados com tiros curtos de 10 segundos promovem redução média de 21% da glicemia, com tendência de aumento na fase de recuperação. O substrato energético predominante na atividade são os carboidratos (CHO). Conclusão: Quanto melhor for o escore z do IMC do adolescente, espera-se melhor controle glicêmico em adolescentes com diabetes tipo 1.Descritores: metabolismo dos carboidratos; diabetes mellitus; oxidação. (r = 0.821, p = 0.024), and there is a strong correlation between pre-exercise and post-exercise glucose (r = 0.851, p = 0.002) and between post-exercise and 30 minutes after exercise (r = 0.874, p = 0.001 ABSTRACT

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Impact of HbA1c, Followed From Onset of Type 1 Diabetes, on the Development of Severe Retinopathy and Nephropathy: The VISS Study (Vascular Diabetic Complications in Southeast Sweden)

Cited by 133 publications

References 38 publications

Correlation of duration, hypertension and glycemic control with microvascular complications of diabetes mellitus at a tertiary care hospital

Correlation of duration, hypertension and glycemic control with microvascular complications of diabetes mellitus at a tertiary care hospital

Empagliflozin as adjunct to insulin in patients with type 1 diabetes: a 4‐week, randomized, placebo‐controlled trial (EASE‐1)

Efeito Agudo Dos Exercícios Intermitentes Sobre a Glicemia De Adolescentes Com Diabetes Tipo 1

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