Prevalence of vascular complications and factors predictive of their development in young adults with type 1 diabetes: systematic literature review

Abstract

BackgroundVascular complications curtail life expectancy and quality of life in type 1 diabetes and development at younger ages is particularly detrimental. To date no review has summarised the prevalence or factors predicting their development in young adults.MethodsA quantitative epidemiological systematic review was conducted to identify the prevalence and predictive factors for development of retinopathy, nephropathy and hypertension in young adults (sample age mean [plus 1SD] 18–30 years) with type 1 diabetes, using processes adapted from established review methods set out by the Centre for Reviews and Dissemination.MEDLINE (Ovid), Scopus (Elsevier), CINAHL, Science Direct (Elsevier), Google Scholar and Cochrane databases were searched to identify relevant articles published between 1993 and June 2014. From this eleven papers were retrieved, appraised and results summarised by three reviewers using established methods.ResultsSome form of retinopathy occurred in up to almost half of participants; more severe forms affected up to one in ten. One in six was reported with microalbuminuria; one in 14 had macroalbuminuria. Hypertension occurred in almost one in two participants. Applying out-dated high thresholds this decreased to approximately one in ten participants. Glycaemic control was a consistent predictor of vascular disease in this age group.ConclusionPrevalence rates of retinopathy, nephropathy and hypertension in young adults with type 1 diabetes emphasise the importance of regular complication screening for early detection and treatment. The predictive effect of glycaemic control reinforces its importance for prevention of vascular complications.Electronic supplementary materialThe online version of this article (doi:10.1186/1756-0500-7-593) contains supplementary material, which is available to authorized users.

Вплив Фітопрепарату BNO 1030 На Фагоцитарну Активність Лейкоцитів Крові При Цукровому Діабеті 1-Го Типу В Щурів

“…According to the obtained data, it becomes apparent that hyperglycemia leads to a decrease in the acti vity of the immune system, which agrees with the results of other authors who found that patients with diabetes form a risk group for susceptibility to infections as a result of reduced immunity [8,11].…”

Renal and Cardiovascular Risk According to Tertiles of Urinary Albumin-to-Creatinine Ratio: The Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT)

“…AdDIT participants will be entering the second/third decade of type 1 diabetes and that critical post-pubertal period when the first direct evidence of vascular complications is observed (30). Thus, ongoing follow up of the cohort could help in answering this relevant question.…”

Expression of CD4+CD28nullT lymphocytes in children and adolescents with type 1 diabetes mellitus: Relation to microvascular complications, aortic elastic properties, and carotid intima media thickness

“…Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disease that involves failure in immune regulation and is characterized by destruction of the insulin‐producing cells by auto‐reactive T cells . The increasing incidence of T1DM in many countries challenges health systems because the disease is presently incurable with no known method of prevention . Diabetes mellitus (DM) is a major risk factor for cardiovascular morbidity and mortality, and the proportion of cardiovascular diseases attributable to DM has increased over the past 50 years .…”