The incidence of type 1 diabetes mellitus (T1DM) is rising. The demands of daily management, blood glucose variability and potential complications pose challenges in management of T1DM.
The aim of this study was to determine the clinical and metabolic profiles of T1DM patients attending Midland Regional Hospital Portlaoise diabetes service in 2017 and to assess their microvascular and macrovascular complications.
A retrospective analysis of data of 106 patients with T1DM was performed. Mean age of the patients was 39.9 ± 14.4 years, 60.4% were males, and mean duration of diabetes was 15.5 ± 12.9 years. 39.6% were overweight (BMI 25 to <30 kg/m2) and 24.5% obese (BMI ≥30 kg/m2). 19.8% had HbA1c < 53 mmol/mol, 25.5% had HbA1c 53 to 63 mmol/mol, 30.2% had HbA1c 64 to 75 mmol/mol and 24.5% had HbA1c > 75 mmol/mol. 66% were within blood pressure target (< 140/90 mmHg). 103 of patients used basal bolus insulin regime, 2 on premixed insulin and one on insulin pump. Only 10.4% did carbohydrate counting to adjust insulin doses. 20.8% had documented hypoglycaemic unawareness. 25.5% had microalbuminuria, 21.7% had background retinopathy, and 11.3% had proliferative retinopathy. Nine were at moderate risk for diabetes foot disease, four at high risk and one had active foot disease.7.5% had coronary artery disease. Our preliminary data demonstrated that overweight/obesity is common and suboptimal glycaemic control and hypoglycaemic unawareness remain significant challenges in our T1DM cohort. Resources to improve T1DM self-management education programmes are essential and use of continuous glucose monitoring and insulin pump in selected patients may overcome these challenges.
05 Sep 2020 - 09 Sep 2020