Model Helps Predict Patient Risk for Major Type 1 Diabetes Complications

Patients diagnosed with type 1 diabetes are at higher risk for developing major health complications but up until now there had been no reliable way to determine which complications a patient might develop or how severe they might be.

Assistant professor Sabita Soedamah-Muthu of Wageningen University in the Netherlands and a team of researchers recently announced the formulation of a new model which they say can help answer this question, with the data published in a recent edition of Diabetologia.

The researchers studied a group of 1,973 type 1 patients in the EURODIAB Prospective Complications Study over the course of 7 years, during which “strong prognostic outcomes were combined into a computer model,” according to a statement on the study.

Out of the group, 95 of patients developed major outcomes including coronary heart disease, stroke, end-stage renal failure, amputations, and blindness as well as all-cause mortality. Prognostic factors used included age, glycated hemoglobin, waist-hip ratio and albumin/creatinine ratio as well as HDL.

The team tested their model in three different prospective cohorts, including the Pittsburgh Epidemiology of Diabetes Complications study, the Finnish Diabetic Nephropathy study, and the Coronary Artery Calcification in Type 1 Diabetes Study.

“The model is pretty well able to distinguish patients who will develop major outcomes from patients who will not develop the outcomes, the authors noted. “After collecting information about the patients’ age, glycated hemoglobin, waist-hip ratio, albumin-creatinine ratio and HDL cholesterol health care professionals can enter this information into the provided score chart and it will automatically work out the 3, 5, and 7 year absolute risks of major outcomes in patients with type 1 diabetes.”

As for why the model would be beneficial to health care providers, the authors said itcan establish a “risk profile” for their patients.

“Physicians may consider active intervention in the identified high risk patients. Such interventions can include intensifying insulin regimen and cardiovascular risk management following existing guidelines,” they wrote.

By finding those patients at greatest risk of the major complications the authors said doctors will know how best to direct their efforts and interventions including insulin, oral glucose-lowering agents, ACE inhibitors, and statins. They may also better be able to recommend diet and lifestyle changes that could mitigate the risk of such severe complications.

Several authors disclosed connections to the pharmaceutical industry.