Type 1 diabetes in older adults: Comparing treatments and chronic complications in the United States T1D Exchange and the German/Austrian DPV registries

T1D Exchange Clinic Network, DPV Initiative

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)28-37
Number of pages10
JournalDiabetes Research and Clinical Practice
Volume122
DOIs
StatePublished - Dec 1 2016
Externally publishedYes

Fingerprint

Type 1 Diabetes Mellitus
Registries
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Nonparametric Statistics
Antihypertensive Agents
Insulin
Blood Pressure
Chi-Square Distribution
LDL Cholesterol
Aspirin
Linear Models
Body Mass Index
Obesity
Cross-Sectional Studies
Smoking
Stroke
Myocardial Infarction
Depression
Therapeutics
Research

Keywords

  • DPV
  • Geriatrics
  • T1D Diabetes Exchange
  • Type 1 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Type 1 diabetes in older adults : Comparing treatments and chronic complications in the United States T1D Exchange and the German/Austrian DPV registries. / T1D Exchange Clinic Network; DPV Initiative.

In: Diabetes Research and Clinical Practice, Vol. 122, 01.12.2016, p. 28-37.

Research output: Contribution to journalArticle

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abstract = "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.",
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author = "{T1D Exchange Clinic Network} and {DPV Initiative} and Weinstock, {Ruth S.} and Ingrid Sch{\"u}tz-Fuhrmann and Connor, {Crystal G.} and Hermann, {Julia M.} and Maahs, {David M.} and Morten Sch{\"u}tt and Shivani Agarwal and Hofer, {Sabine E.} and Beck, {Roy W.} and Holl, {Reinhard W.}",
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AU - Schütz-Fuhrmann, Ingrid

AU - Connor, Crystal G.

AU - Hermann, Julia M.

AU - Maahs, David M.

AU - Schütt, Morten

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KW - T1D Diabetes Exchange

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