TY - JOUR
T1 - Type 1 diabetes in older adults
T2 - Comparing treatments and chronic complications in the United States T1D Exchange and the German/Austrian DPV registries
AU - T1D Exchange Clinic Network
AU - DPV Initiative
AU - Weinstock, Ruth S.
AU - Schütz-Fuhrmann, Ingrid
AU - Connor, Crystal G.
AU - Hermann, Julia M.
AU - Maahs, David M.
AU - Schütt, Morten
AU - Agarwal, Shivani
AU - Hofer, Sabine E.
AU - Beck, Roy W.
AU - Holl, Reinhard W.
N1 - Publisher Copyright:
© 2016 Elsevier Ireland Ltd
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Aims Compare characteristics, therapies and clinical outcomes in older adults with type 1 diabetes in the United States T1D Exchange (T1DX) and German/Austrian Diabetes Patienten Verlaufsdokumentation (DPV) registries. Methods Cross-sectional study of adults ≥60 years old with type 1 diabetes seen in 2011–2012 in the T1DX (n = 1283) and DPV (n = 2014) registries. Wilcoxon rank-sum test was used for continuous variables and chi-square test for categorical variables. Adjusted analyses used generalized linear models. Results Individuals in both registries were similar in body mass index (mean 27 kg/m2), percent with obesity (25%) and gender (48% male). In T1DX there was longer diabetes duration (32.3 vs. 28.8 years), greater use of antihypertensive medications (including ACE-I and ARBs; 85% vs. 62%), statins (68% vs. 40%), aspirin (77% vs. 21%), insulin pumps (58% vs. 18%), and less smoking (7% vs. 10%); lower adjusted mean LDL-cholesterol (84 vs. 109 mg/dL), and lower adjusted mean systolic and diastolic blood pressures (128 vs. 136 and 68 vs. 74 mmHg); fewer myocardial infarctions (6% vs. 9% [99% CI of difference, 1% to 5%]), strokes (2% vs. 8% [3% to 7%]), microvascular complications including microalbuminuria (17% vs. 44% [22% to 32%]) but increased depression (16.1% vs. 8.7%). Adjusted mean HbA1c levels were similar (7.5%, 58 mmol/mol). Conclusions Differences between the registries included greater use of antihypertensives, statins and insulin pumps, and fewer chronic complications in the T1DX. Further research is needed to better understand the role of intensive therapy in improving outcomes in older adults with type 1 diabetes.
AB - Aims Compare characteristics, therapies and clinical outcomes in older adults with type 1 diabetes in the United States T1D Exchange (T1DX) and German/Austrian Diabetes Patienten Verlaufsdokumentation (DPV) registries. Methods Cross-sectional study of adults ≥60 years old with type 1 diabetes seen in 2011–2012 in the T1DX (n = 1283) and DPV (n = 2014) registries. Wilcoxon rank-sum test was used for continuous variables and chi-square test for categorical variables. Adjusted analyses used generalized linear models. Results Individuals in both registries were similar in body mass index (mean 27 kg/m2), percent with obesity (25%) and gender (48% male). In T1DX there was longer diabetes duration (32.3 vs. 28.8 years), greater use of antihypertensive medications (including ACE-I and ARBs; 85% vs. 62%), statins (68% vs. 40%), aspirin (77% vs. 21%), insulin pumps (58% vs. 18%), and less smoking (7% vs. 10%); lower adjusted mean LDL-cholesterol (84 vs. 109 mg/dL), and lower adjusted mean systolic and diastolic blood pressures (128 vs. 136 and 68 vs. 74 mmHg); fewer myocardial infarctions (6% vs. 9% [99% CI of difference, 1% to 5%]), strokes (2% vs. 8% [3% to 7%]), microvascular complications including microalbuminuria (17% vs. 44% [22% to 32%]) but increased depression (16.1% vs. 8.7%). Adjusted mean HbA1c levels were similar (7.5%, 58 mmol/mol). Conclusions Differences between the registries included greater use of antihypertensives, statins and insulin pumps, and fewer chronic complications in the T1DX. Further research is needed to better understand the role of intensive therapy in improving outcomes in older adults with type 1 diabetes.
KW - DPV
KW - Geriatrics
KW - T1D Diabetes Exchange
KW - Type 1 diabetes
UR - http://www.scopus.com/inward/record.url?scp=84992096791&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84992096791&partnerID=8YFLogxK
U2 - 10.1016/j.diabres.2016.09.024
DO - 10.1016/j.diabres.2016.09.024
M3 - Article
C2 - 27764721
AN - SCOPUS:84992096791
SN - 0168-8227
VL - 122
SP - 28
EP - 37
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
ER -