The prevalence of microvascular complications in Waikato children and youth with type 1 diabetes has reduced since 2003

N Z Med J. 2020 Feb 21;133(1510):35-44.

Abstract

Aims: To determine whether glycaemic control and the prevalence of microvascular complications in Waikato children/youth with type 1 diabetes (T1D) has changed since 2003.

Methods: A retrospective review was performed of clinical records of children and youth with T1D who were under the care of the Waikato Paediatric and Young Adult Diabetes Services between March 2016 and March 2017. Comparisons were made to published data from the same service in 2003.

Results: Despite a more than two-fold increase in insulin-pump therapy since 2003, glycaemic control was not significantly improved in either children or youth. However, since 2003 there has been a significant reduction in the prevalence of diabetic retinopathy (24.6% vs 6.0%; P=0.003) and nephropathy (6.0% vs 25.4%; P=0.002), while symptomatic diabetic neuropathy remains rare. This reduction occurred despite a significant increase in obesity and hypertension, and no significant difference in the rates of dyslipidaemia or smoking.

Conclusions: There has been a marked reduction in microvascular complications in Waikato youth and young adults with type 1 diabetes, but the reasons for the reduction are not clear given there has been no significant improvements in glycaemic control.

MeSH terms

  • Adolescent
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / ethnology
  • Diabetic Nephropathies / ethnology*
  • Diabetic Nephropathies / etiology
  • Diabetic Neuropathies / ethnology*
  • Diabetic Neuropathies / etiology
  • Diabetic Retinopathy / ethnology*
  • Diabetic Retinopathy / etiology
  • Female
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Infant
  • Infant, Newborn
  • Male
  • Native Hawaiian or Other Pacific Islander*
  • New Zealand / epidemiology
  • Prevalence
  • Retrospective Studies

Substances

  • Biomarkers
  • Blood Glucose
  • Hypoglycemic Agents