Endocrine Abstracts

According to the current expert recommendations it is advisable to screen microvascular complications: diabetic peripheral polyneuropathy (DPN), diabetic retinopathy (DR), diabetic nephropathy (DN) in all patients with type 1 diabetes mellitus (T1D) and disease duration of 5 years. Therefore, the aim of the study was to assess the clinical and laboratory parameters of patients with type 1 diabetes at the age of 30−45 years with duration of the disease 5–15 years, taking into account adherence to the implementation of recommendations for the control of glycemia.

Materials and methods: 360 T1D patients, 196 (54.4%) men and 164 (45.6%) women were examined. The average age of the patients was 37.9±4.5 (37.4−38.4) years, the age of diabetes onset – 28.1±6.2 (27.5−28.8) years, duration of the disease – 9.0 (7.0−12.0) years, body mass index – 24.8±3.95 (23.6−25.2) kg/m². The study carried out a detailed clinical examination of patients with medical record analysis. The study was conducted within the framework of the nationwide action ‘Early Detection of Chronic Complications of Type 1 Diabetes Mellitus in Adults’. Patients completed questionnaires of adherence to the implementation of recommendations for the glycemic control, the results of which were divided into two groups: 1st group (Gr1)−257 (71.4%) people − predominantly compliant patients, 2nd (Gr2)−103 (28.6%) people − mostly not committed to the control of glycemia. To verify the DPN the Vibratip device also used.

Results: In 36.9% cases DPN was diagnosed; DR – in 21.7%, DN − in 40.6%, albuminuria – in 38.1% cases. Microvascular diabetic complications were in 270 (75%) patients. The level of Hb_A1c, used to estimate the compensation of glycemia, averaged 8.37±1.83 (8.18−8.56), while in Gr1 the index was significantly lower than in Gr2: 8.20±1, 83 vs 8.80±1.75%, however, in both groups, the target values were not achieved. There were significant differences in groups in the presence of DPN − 33.5 vs 45.6% (χ²=4.67, P=0.030), microvascular complication − 71.6 vs 83.5% (χ²=5.55, P=0.018). However, there were no differences in the prevalence groups of DN − 62.6 vs 51.5% (χ²=4.67, P=0.051), albuminuria 35.4 vs 44.7% (χ²=4.67, P=0.030), DR − 51.4 vs 54.4% (χ²=2.66, P=0.102).

Conclusions: In 75% cases of T1D fixed microvascular complications. Adherence to the control of glycemia without reaching the target values is associated with the diabetic neuropathy, but does not affect the development of diabetic retinopathy and nephropathy.