Endocrine Abstracts

People living with type 1 diabetes (T1DM) for decades remain at risk for chronic complications despite advances in management. Identifying clinical and treatment-related factors associated with these complications can help guide prevention and management. We conducted a retrospective chart review of adults with T1DM of ≥25 years’ duration attending a single clinic. Data included demographics, duration, glycated haemoglobin (HbA1c), body mass index (BMI), smoking status, insulin pump use, continuous glucose monitoring, antihypertensives, lipid-lowering agents, aspirin and glucagon-like peptide-1 (GLP-1) receptor agonists. Complications were defined as any microvascular or macrovascular condition. Statistical analysis included chi-square, Mann-Whitney U, Spearman’s correlations and Kruskal-Wallis tests. Variables with P < 0.10 entered multivariable logistic regression. A total of 132 patients (50.8% male, median age 53 years [IQR 35-62], median duration 32 years [IQR 28-41]) were included. Current smoking (P < 0.001), use of antihypertensives (P = 0.003), and aspirin (P = 0.031) were significantly associated with the presence of complications. Later age of onset (> 18 years) was linked to a higher number of all complications (P = 0.018), including greater prevalence of nephropathy (P = 0.045), peripheral neuropathy (P = 0.013) and cardiovascular disease (P < 0.001). Logistic regression (Nagelkerke R 2=0.305; P = 0.004; 78.8% correctly classified) identified smoking as the sole independent predictor (OR 19.96, 95% CI 2.85-140.01, P = 0.003), with pump use showing a non-significant protective trend (P = 0.076). In this cohort, later age at diagnosis and smoking were associated with greater complication burden, though only smoking remained significant after adjustment. These findings highlight smoking cessation as a key modifiable target and underscore the importance of prioritising preventive strategies in this population.