Ann Pediatr Endocrinol Metab.  2012 Mar;17(1):16-26. 10.6065/apem.2012.17.1.16.

Frequencies and Related Factors for Microvascular Complications in Patients with Type 1 Diabetes

Affiliations
  • 1Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea. kimho@yuhs.ac.kr
  • 2Sowha Children's Hospital, Seoul, Korea.

Abstract

PURPOSE
We observed the frequencies of microvascular complications and their related factors in patients with type 1 diabetes.
METHODS
Two hundred seventy one patients (111 males and 160 females, mean age 21.9 +/- 5.8 years) with type 1 diabetes were included. Subjects were all at least 10 years old and had diabetes for at least two years. Three types of microvascular complications (diabetic nephropathy, retinopathy, and neuropathy) were evaluated, and their frequencies and risk factors were analyzed.
RESULTS
The overall prevalence of microvascular disease was 83/271 (30.6%). Microalbuminuria had developed in 39 patients (14.4%), persistent microalbuminuria in 31 patients (11.4%), and proteinuria in 12 (4.4%). Diabetic retinopathy had developed in 35 patients (12.9%) and neuropathy in 39 patients (13.7%). The mean HbA1c for 10 years was significantly higher in the patients with microvascular complications (10.5 +/- 2.8% vs. 8.4 +/- 1.4%). The rate of intensive management in the non-complication group was higher than in the microvascular complication group. The incidence of microalbuminuria was greater in males than females, but there were no gender differences in either diabetic retinopathy or neuropathy. Puberty and the duration of diabetes may be associated with microvascular complications.
CONCLUSION
The incidence of microvascular complications in type 1 diabetes is declining. Sex, puberty, and the duration of diabetes as well as prolonged hyperglycemia are all related to microvascular complications. Therefore, intensive insulin management and regular screening for microvascular complications should be performed in patients who have either entered into puberty or have had diabetes for more than 5 years.

Keyword

Diabetes complications; Diabetes mellitus, type 1; Incidence; Risk factors

MeSH Terms

Diabetes Complications
Diabetes Mellitus, Type 1
Diabetic Retinopathy
Female
Humans
Hyperglycemia
Incidence
Insulin
Male
Mass Screening
Prevalence
Proteinuria
Puberty
Risk Factors
Insulin
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