Endocrine Abstracts

Introduction

Type 1 diabetes (T1D), also known as juvenile diabetes, commonly occurs in young individuals. However, autoimmune diabetes may be diagnosed in the elderly, with different clinical and biological aspects. The aim of our study is to identify the prevalence of and risk factors for microvascular complications related to T1D diagnosed during adulthood.

Patients and methods

A retrospective study, from 2010 to 2019, including 166 patients diagnosed with T1D occurred after the age of 20, with positive anti-pancreatic antibodies (Anti GAD, Anti ICA and/or Anti IA2). The incidence of microvascular complications and potential predictive factors were analyzed.

Results

Mean age was 31.81 years (95 males vs 71 females). Mean diabetes duration was 7.34 ± 6.73 years (2 months-44.5 years) and 57.8% of patients had diabetes that had progressed for at least 5 years. Microvascular complications occurred in 21.5% of patients. A total of 16 patients (9.6%) had diabetic retinopathy after a mean diabetes duration of 13.23–9.26 years (0.7–38 years). Diabetic kidney disease was observed in 6% of patients after an average duration of diabetes of 16.7 ± 6.68 years. The mean urea and creatinine level was 5.35 mmol/l and 75.8 umol/l, respectively. The prevalence of albuminuria was 7.2%. Seven patients underwent hemodialysis for end-stage renal disease. Peripheral neuropathy complicated diabetes in 18.1 % of patients after a mean duration of 9.66 ± 7.55 years (1–30 years). Only 15 patients had cardiovascular autonomic neuropathy: urogenital dysfunction in 14 patients, gastroparesis in 3 patients and orthostatic hypotension in 1 patient. Diabetic retinopathy and kidney disease were both significantly more common in men (P < 0.05).A higher prevalence of diabetic retinopathy was significantly observed in patients with longer diabetes duration (P < 0.05). Patients who developed diabetic kidney disease were significantly older (P < 0.05). Furthermore, there was a significant correlation between this complication and high blood pressure. Diabetic kidney disease was also significantly associated with an increased incidence of diabetic retinopathy, hypertension and macrovascular complications. Diabetic neuropathy was significantly related to diabetes duration, age, basal metabolic index (BMI) and creatinine clearance (P < 0.05).

Conclusion

Among adults who had been diagnosed with T1D, screening of microvascular complications remains a crucial step in T1D’s management. Their early identification helps to reduce their adverse repercussions.