Renal Complications and Duration of Diabetes: An International Comparison in Persons with Type 1 Diabetes

Abstract

Introduction: Renal complications are both a marker of previous suboptimal glycaemic control and a major risk factor for cardiovascular disease in persons with type 1 diabetes (T1D). The aim of the study was to evaluate the prevalence of renal complications in persons with T1D in four geographical regions. Methods: Nationwide registry data from Austria/Germany, Sweden and the US were used to estimate the prevalence of renal complications from January 2016 until September 2018.Chronic kidney disease (CKD) and albuminuria in the study population and each registry were analysed by diabetes duration. Risk factors for renal complications were described by registry. Results: In the total cohort of 78.926 adults with T1D, mean age was 44.4 ± 18.43 years and mean diabetes duration was 21.6 ± 22 years. Mean estimated glomerular filtration rate (eGFR) was 94.0 ± 31.45 ml/min, 13.0% had microalbuminuria and 3.9% had macroalbuminuria. Mean age, diabetes duration, use of insulin pumps and continuous glucose monitoring, as well as presence of albuminuria, varied between registries. Albuminuria was present in approximately 10% of persons with diabetes

Risk factors, mortality trends, and cardiovascular diseases in people with Type 1 diabetes and controls in Sweden: An observational cohort study

“…In a recent study including patients from four countries, renal complications were still common in patients with diabetes onset over the last 20 years, and the majority of patients had glucose levels above target. 36 Hence, improved prevention in people with T1D and cardiorenal complications should be the focus of attention in clinical practice and research to reduce the gap in mortality over time.…”

Performance of Dexcom G5 and FreeStyle Libre sensors tested simultaneously in people with type 1 or 2 diabetes and advanced chronic kidney disease

“…It is estimated that 20%-40% of people with diabetes will develop diabetic kidney disease, and it is the leading cause of end-stage renal failure[ 5 , 6 ]. A recent study showed that up to 5.1% of people with type 1 diabetes in Germany and Austria had an estimated glomerular filtration rate (eGFR) below 30 mL/min, and for Sweden and United States, the corresponding figures were 1.5% and 2.1%[ 7 ]. Advanced CKD increases the risk of hypoglycemia and great glycemic variation, and therefore it can be helpful to monitor blood glucose with a CGM or isCGM[ 8 , 9 ].…”