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New research published in Diabetologia (the journal of the European Association for the Study of Diabetes) presents a new model for predicting which patients with type 1 diabetes will go on to develop major complications, through easily and routinely measured risk factors.
Accurate predictions
To create the model, data were analysed from 1,973 participants with type 1 diabetes followed for seven years in a particular study. From this, strong prognostic factors were combined into a computer model.
The study focused on complications such as severe coronary heart disease, stroke, end-stage renal failure, amputations, blindness and all-cause mortality. Certain factors, linked to such complications, including age, glycated haemoglobin, waist-hip ratio, albumin/creatinine ratio and HDL- (good) cholesterol were considered in the study.
Read: Recognising diabetes complications
After certain corrections were made, the model was able to accurately predict the patients' risk. "The model is pretty well able to distinguish patients who will develop major outcomes from patients who will not develop the outcomes," say the authors. "After collecting information about the patients' age, glycated haemoglobin, 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."
Reducing health care costs
They add, "Accurate risk predictions in individual patients with type 1 diabetes are important to timely identify the patients at high risk of major outcomes in order to enable strategies to prevent the development of such complications and to reduce health care costs."
The authors highlight that the model can be used to help patients at high risk by treating all manageable risk factors. "Predicting major outcomes permits establishment of a risk profile for individual patients with type 1 diabetes," they say. "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.
Read: Controlling type 1 diabetes
In more detail, these findings will help to identify those at greatest risk and provide them with the proper preventative treatment. Examples of such treatment includes insulin, oral glucose lowering agents, ACE inhibitors, angiotensin receptor blockers, statins, diet and lifestyle management."
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