TY - JOUR
T1 - Achievement of treatment targets predicts progression of vascular complications in type 1 diabetes
AU - Salna, Ilze
AU - Salna, Edgars
AU - Pahirko, Leonora
AU - Skrebinska, Sabīne
AU - Krikova, Regīna
AU - Folkmane, Inese
AU - Pīrāgs, Valdis
AU - Sokolovska, Jelizaveta
N1 - Funding Information:
The study was supported by fundamental research grant in Biomedicine and Pharmacy ?Research of biomarkers and natural substances for acute and chronic diseases' diagnostics and personalized treatment? by the Faculty of Medicine, University of Latvia and Genome Database of the Latvian population.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/12
Y1 - 2021/12
N2 - Background and aim: To study the association between achievement of guideline-defined treatment targets on HbA1c, low-density lipoproteins (LDL-C), and blood pressure with the progression of diabetic complications in patients with type 1 diabetes (T1D). Methods: The study included 355 patients at baseline and 114 patients with follow-up data after 3–5 years. Outcome variables were the progression of diabetic kidney disease, retinopathy, or cardiovascular disease (CVD). We used logistic regression and other machine learning algorithms (MLA) to model the association of achievement of treatment targets and probability of progression of complications. Results: Achievement of the target blood pressure was associated with 96% lower odds of a new CVD event (0.04 (95% CI 0.00, 0.53), p = 0.016), and 72% lower odds of progression of any complication (0.28 (95% CI 0.09, 0.89), p = 0.027. Achievement of HbA1c target was associated with lower odds of composite complication progression by 82% (0.18 (95% CI 0.04, 0.88), p = 0.034.) None of the patients who achieved HbA1c target progressed in CVD. MLA demonstrated good accuracy for the prediction of progression of CVD (AUC 0.824), and lower accuracy for other complications. Conclusion: The achievement of blood pressure and HbA1c treatment targets is associated with lower odds of vascular complication of T1D in a real life study.
AB - Background and aim: To study the association between achievement of guideline-defined treatment targets on HbA1c, low-density lipoproteins (LDL-C), and blood pressure with the progression of diabetic complications in patients with type 1 diabetes (T1D). Methods: The study included 355 patients at baseline and 114 patients with follow-up data after 3–5 years. Outcome variables were the progression of diabetic kidney disease, retinopathy, or cardiovascular disease (CVD). We used logistic regression and other machine learning algorithms (MLA) to model the association of achievement of treatment targets and probability of progression of complications. Results: Achievement of the target blood pressure was associated with 96% lower odds of a new CVD event (0.04 (95% CI 0.00, 0.53), p = 0.016), and 72% lower odds of progression of any complication (0.28 (95% CI 0.09, 0.89), p = 0.027. Achievement of HbA1c target was associated with lower odds of composite complication progression by 82% (0.18 (95% CI 0.04, 0.88), p = 0.034.) None of the patients who achieved HbA1c target progressed in CVD. MLA demonstrated good accuracy for the prediction of progression of CVD (AUC 0.824), and lower accuracy for other complications. Conclusion: The achievement of blood pressure and HbA1c treatment targets is associated with lower odds of vascular complication of T1D in a real life study.
KW - Complication
KW - Machine learning
KW - Treatment targets
KW - Type 1 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85116739936&partnerID=8YFLogxK
U2 - 10.1016/j.jdiacomp.2021.108072
DO - 10.1016/j.jdiacomp.2021.108072
M3 - Article
C2 - 34635403
AN - SCOPUS:85116739936
SN - 1056-8727
VL - 35
JO - Journal of Diabetes and its Complications
JF - Journal of Diabetes and its Complications
IS - 12
M1 - 108072
ER -
