Heterogeneous long‐term trajectories of glycaemic control in type 1 diabetes
Aims We aimed to identify long‐term HbA1c trajectories and examine associated characteristics in an observational, childhood‐onset (
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| Veröffentlicht in: | Diabetic medicine 2021-08, Vol.38 (8), p.e14545-n/a |
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| creator | Miller, Rachel G. Orchard, Trevor J. Onengut‐Gumuscu, Suna Chen, Wei‐Min Rich, Stephen S. Costacou, Tina |
| description | Aims
We aimed to identify long‐term HbA1c trajectories and examine associated characteristics in an observational, childhood‐onset ( |
| doi_str_mv | 10.1111/dme.14545 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmed_primary_33605492</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2553528285</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4435-b8ac78f6347de0f665bb8ed07e3f92706ee45cdaaf2a4e5db7fe52e47f972fb13</originalsourceid><addsrcrecordid>eNp1kc1O3DAURi1EVYZpF7wAssSmLAL-jZMNEgJaKgHdtGvLca4Hj5J4sDNUs-MReEaepIaZolIJbyzZR0ffvR9Ce5Qc0XyO2x6OqJBCbqEJFaUopKjpNpoQJVjBiaI7aDelOSGU1bz-iHY4L0lm2ATdXMIIMcxggLBMuAvD7OnhMT_1eIxmDnYM0UPCweFZt7IGem-xDcMYQ4f9gMfVAjDFrTdNFqVP6IMzXYLPm3uKfn29-Hl2WVz9-Pb97PSqsEJwWTSVsapyJReqBeLKUjZNBS1RwF3NFCkBhLStMY4ZAbJtlAPJQChXK-YayqfoZO1dLJseWgs5kOn0IvrexJUOxuu3P4O_1bNwrytWS6rKLPiyEcRwt4Q06t4nC11nXhahWd5gLSpGntGD_9B5WMYhj6eZlFyyilUyU4drysaQUgT3GoYS_dySzi3pl5Yyu_9v-lfyby0ZOF4Dv30Hq_dN-vz6Yq38A0hTnnQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2553528285</pqid></control><display><type>article</type><title>Heterogeneous long‐term trajectories of glycaemic control in type 1 diabetes</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Miller, Rachel G. ; Orchard, Trevor J. ; Onengut‐Gumuscu, Suna ; Chen, Wei‐Min ; Rich, Stephen S. ; Costacou, Tina</creator><creatorcontrib>Miller, Rachel G. ; Orchard, Trevor J. ; Onengut‐Gumuscu, Suna ; Chen, Wei‐Min ; Rich, Stephen S. ; Costacou, Tina</creatorcontrib><description>Aims
We aimed to identify long‐term HbA1c trajectories and examine associated characteristics in an observational, childhood‐onset (<17 years) type 1 diabetes cohort.
Methods
Data are from the Epidemiology of Diabetes Complications study, comprising 405 participants with ≥2 of seven possible HbA1c measurements over follow‐up (1988–2013) and available DNA (baseline mean diabetes duration 21 years, 53% men). HbA1c trajectories were estimated using latent class growth models. Baseline and change in participant characteristics were compared across trajectories.
Results
Five HbA1c trajectories were identified: low (51%), intermediate stable (22%), improved (19%), high stable (6%), and worsened (2%; not included in analyses). Age, diabetes duration, diabetes onset age, and sex did not differ across trajectories. Characteristics did not differ significantly between intermediate stable and low trajectories at baseline, though albumin excretion rate (AER, p = 0.0002) and estimated glomerular filtration rate (eGFR, p = 0.001) worsened slightly more in intermediate stable over time. Improved and high stable trajectories had higher baseline LDL‐c (p = 0.002 and 0.003, respectively). Improved trajectory increased median self‐monitoring of blood glucose from <1 to 3.5 times/day (p < 0.0001) and had larger LDL‐c improvement (p = 0.004) but greater worsening of AER (p < 0.0001) and eGFR (p < 0.0001) than low. The A allele of rs12970134 (near MC4R) was associated with improved (p = 0.0003) or high stable (p = 0.001) HbA1c trajectory, both patterns with high baseline HbA1c.
Conclusions
Long‐term HbA1c trajectories were primarily associated with modifiable factors in this type 1 diabetes cohort. The intermediate stable pattern had a risk factor profile that suggests some protection against adverse metabolic effects of chronic hyperglycaemia, warranting further study.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1111/dme.14545</identifier><identifier>PMID: 33605492</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adult ; Blood Glucose - metabolism ; Children ; Cohort analysis ; cohort study ; Diabetes ; Diabetes mellitus (insulin dependent) ; Diabetes Mellitus, Type 1 - blood ; Epidemiology ; Epidermal growth factor receptors ; Female ; Follow-Up Studies ; Forecasting ; Glomerular filtration rate ; Glucose ; glycaemic control ; Glycated Hemoglobin A - metabolism ; Glycemic Control ; Growth models ; HbA1c ; Hemoglobin ; Humans ; Hyperglycemia ; Latent class analysis ; latent class growth models ; Low density lipoprotein ; Male ; Prospective Studies ; Risk Factors ; trajectories ; type 1 diabetes ; Young Adult</subject><ispartof>Diabetic medicine, 2021-08, Vol.38 (8), p.e14545-n/a</ispartof><rights>2021 Diabetes UK</rights><rights>2021 Diabetes UK.</rights><rights>Diabetic Medicine © 2021 Diabetes UK</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4435-b8ac78f6347de0f665bb8ed07e3f92706ee45cdaaf2a4e5db7fe52e47f972fb13</citedby><cites>FETCH-LOGICAL-c4435-b8ac78f6347de0f665bb8ed07e3f92706ee45cdaaf2a4e5db7fe52e47f972fb13</cites><orcidid>0000-0003-1845-8477 ; 0000-0001-9303-3810</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdme.14545$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdme.14545$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33605492$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Miller, Rachel G.</creatorcontrib><creatorcontrib>Orchard, Trevor J.</creatorcontrib><creatorcontrib>Onengut‐Gumuscu, Suna</creatorcontrib><creatorcontrib>Chen, Wei‐Min</creatorcontrib><creatorcontrib>Rich, Stephen S.</creatorcontrib><creatorcontrib>Costacou, Tina</creatorcontrib><title>Heterogeneous long‐term trajectories of glycaemic control in type 1 diabetes</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>Aims
We aimed to identify long‐term HbA1c trajectories and examine associated characteristics in an observational, childhood‐onset (<17 years) type 1 diabetes cohort.
Methods
Data are from the Epidemiology of Diabetes Complications study, comprising 405 participants with ≥2 of seven possible HbA1c measurements over follow‐up (1988–2013) and available DNA (baseline mean diabetes duration 21 years, 53% men). HbA1c trajectories were estimated using latent class growth models. Baseline and change in participant characteristics were compared across trajectories.
Results
Five HbA1c trajectories were identified: low (51%), intermediate stable (22%), improved (19%), high stable (6%), and worsened (2%; not included in analyses). Age, diabetes duration, diabetes onset age, and sex did not differ across trajectories. Characteristics did not differ significantly between intermediate stable and low trajectories at baseline, though albumin excretion rate (AER, p = 0.0002) and estimated glomerular filtration rate (eGFR, p = 0.001) worsened slightly more in intermediate stable over time. Improved and high stable trajectories had higher baseline LDL‐c (p = 0.002 and 0.003, respectively). Improved trajectory increased median self‐monitoring of blood glucose from <1 to 3.5 times/day (p < 0.0001) and had larger LDL‐c improvement (p = 0.004) but greater worsening of AER (p < 0.0001) and eGFR (p < 0.0001) than low. The A allele of rs12970134 (near MC4R) was associated with improved (p = 0.0003) or high stable (p = 0.001) HbA1c trajectory, both patterns with high baseline HbA1c.
Conclusions
Long‐term HbA1c trajectories were primarily associated with modifiable factors in this type 1 diabetes cohort. The intermediate stable pattern had a risk factor profile that suggests some protection against adverse metabolic effects of chronic hyperglycaemia, warranting further study.</description><subject>Adult</subject><subject>Blood Glucose - metabolism</subject><subject>Children</subject><subject>Cohort analysis</subject><subject>cohort study</subject><subject>Diabetes</subject><subject>Diabetes mellitus (insulin dependent)</subject><subject>Diabetes Mellitus, Type 1 - blood</subject><subject>Epidemiology</subject><subject>Epidermal growth factor receptors</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Forecasting</subject><subject>Glomerular filtration rate</subject><subject>Glucose</subject><subject>glycaemic control</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Glycemic Control</subject><subject>Growth models</subject><subject>HbA1c</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Latent class analysis</subject><subject>latent class growth models</subject><subject>Low density lipoprotein</subject><subject>Male</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>trajectories</subject><subject>type 1 diabetes</subject><subject>Young Adult</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1O3DAURi1EVYZpF7wAssSmLAL-jZMNEgJaKgHdtGvLca4Hj5J4sDNUs-MReEaepIaZolIJbyzZR0ffvR9Ce5Qc0XyO2x6OqJBCbqEJFaUopKjpNpoQJVjBiaI7aDelOSGU1bz-iHY4L0lm2ATdXMIIMcxggLBMuAvD7OnhMT_1eIxmDnYM0UPCweFZt7IGem-xDcMYQ4f9gMfVAjDFrTdNFqVP6IMzXYLPm3uKfn29-Hl2WVz9-Pb97PSqsEJwWTSVsapyJReqBeLKUjZNBS1RwF3NFCkBhLStMY4ZAbJtlAPJQChXK-YayqfoZO1dLJseWgs5kOn0IvrexJUOxuu3P4O_1bNwrytWS6rKLPiyEcRwt4Q06t4nC11nXhahWd5gLSpGntGD_9B5WMYhj6eZlFyyilUyU4drysaQUgT3GoYS_dySzi3pl5Yyu_9v-lfyby0ZOF4Dv30Hq_dN-vz6Yq38A0hTnnQ</recordid><startdate>202108</startdate><enddate>202108</enddate><creator>Miller, Rachel G.</creator><creator>Orchard, Trevor J.</creator><creator>Onengut‐Gumuscu, Suna</creator><creator>Chen, Wei‐Min</creator><creator>Rich, Stephen S.</creator><creator>Costacou, Tina</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1845-8477</orcidid><orcidid>https://orcid.org/0000-0001-9303-3810</orcidid></search><sort><creationdate>202108</creationdate><title>Heterogeneous long‐term trajectories of glycaemic control in type 1 diabetes</title><author>Miller, Rachel G. ; Orchard, Trevor J. ; Onengut‐Gumuscu, Suna ; Chen, Wei‐Min ; Rich, Stephen S. ; Costacou, Tina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4435-b8ac78f6347de0f665bb8ed07e3f92706ee45cdaaf2a4e5db7fe52e47f972fb13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Blood Glucose - metabolism</topic><topic>Children</topic><topic>Cohort analysis</topic><topic>cohort study</topic><topic>Diabetes</topic><topic>Diabetes mellitus (insulin dependent)</topic><topic>Diabetes Mellitus, Type 1 - blood</topic><topic>Epidemiology</topic><topic>Epidermal growth factor receptors</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Forecasting</topic><topic>Glomerular filtration rate</topic><topic>Glucose</topic><topic>glycaemic control</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Glycemic Control</topic><topic>Growth models</topic><topic>HbA1c</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Hyperglycemia</topic><topic>Latent class analysis</topic><topic>latent class growth models</topic><topic>Low density lipoprotein</topic><topic>Male</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>trajectories</topic><topic>type 1 diabetes</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miller, Rachel G.</creatorcontrib><creatorcontrib>Orchard, Trevor J.</creatorcontrib><creatorcontrib>Onengut‐Gumuscu, Suna</creatorcontrib><creatorcontrib>Chen, Wei‐Min</creatorcontrib><creatorcontrib>Rich, Stephen S.</creatorcontrib><creatorcontrib>Costacou, Tina</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miller, Rachel G.</au><au>Orchard, Trevor J.</au><au>Onengut‐Gumuscu, Suna</au><au>Chen, Wei‐Min</au><au>Rich, Stephen S.</au><au>Costacou, Tina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Heterogeneous long‐term trajectories of glycaemic control in type 1 diabetes</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2021-08</date><risdate>2021</risdate><volume>38</volume><issue>8</issue><spage>e14545</spage><epage>n/a</epage><pages>e14545-n/a</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><abstract>Aims
We aimed to identify long‐term HbA1c trajectories and examine associated characteristics in an observational, childhood‐onset (<17 years) type 1 diabetes cohort.
Methods
Data are from the Epidemiology of Diabetes Complications study, comprising 405 participants with ≥2 of seven possible HbA1c measurements over follow‐up (1988–2013) and available DNA (baseline mean diabetes duration 21 years, 53% men). HbA1c trajectories were estimated using latent class growth models. Baseline and change in participant characteristics were compared across trajectories.
Results
Five HbA1c trajectories were identified: low (51%), intermediate stable (22%), improved (19%), high stable (6%), and worsened (2%; not included in analyses). Age, diabetes duration, diabetes onset age, and sex did not differ across trajectories. Characteristics did not differ significantly between intermediate stable and low trajectories at baseline, though albumin excretion rate (AER, p = 0.0002) and estimated glomerular filtration rate (eGFR, p = 0.001) worsened slightly more in intermediate stable over time. Improved and high stable trajectories had higher baseline LDL‐c (p = 0.002 and 0.003, respectively). Improved trajectory increased median self‐monitoring of blood glucose from <1 to 3.5 times/day (p < 0.0001) and had larger LDL‐c improvement (p = 0.004) but greater worsening of AER (p < 0.0001) and eGFR (p < 0.0001) than low. The A allele of rs12970134 (near MC4R) was associated with improved (p = 0.0003) or high stable (p = 0.001) HbA1c trajectory, both patterns with high baseline HbA1c.
Conclusions
Long‐term HbA1c trajectories were primarily associated with modifiable factors in this type 1 diabetes cohort. The intermediate stable pattern had a risk factor profile that suggests some protection against adverse metabolic effects of chronic hyperglycaemia, warranting further study.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33605492</pmid><doi>10.1111/dme.14545</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1845-8477</orcidid><orcidid>https://orcid.org/0000-0001-9303-3810</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Blood Glucose - metabolism Children Cohort analysis cohort study Diabetes Diabetes mellitus (insulin dependent) Diabetes Mellitus, Type 1 - blood Epidemiology Epidermal growth factor receptors Female Follow-Up Studies Forecasting Glomerular filtration rate Glucose glycaemic control Glycated Hemoglobin A - metabolism Glycemic Control Growth models HbA1c Hemoglobin Humans Hyperglycemia Latent class analysis latent class growth models Low density lipoprotein Male Prospective Studies Risk Factors trajectories type 1 diabetes Young Adult |
| title | Heterogeneous long‐term trajectories of glycaemic control in type 1 diabetes |
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