Scholarlink

Aims <p>To examine the association between within-person variability in glycated hemoglobin A1c (HbA1c) and blood pressure (BP) with retinopathy and nephropathy in type 1 diabetes (T1D).</p> Methods <p>This nationwide cohort included 9,358 individuals from the Swedish National Diabetes Register with T1D &lt;5 years at inclusion (1998–2017) and ≥8 years follow-up. Variability in HbA1c, systolic BP (SBP), and diastolic BP (DBP) was calculated as updated SDs. Associations with microvascular complications were analyzed using logistic regression with generalized estimating equations, adjusted for demographic and clinical covariates.</p> Results <p>Mean age at inclusion was 14.2 years, mean diabetes duration 1.2 years, and 44% were female. Over 10.7 years’ follow-up, retinopathy developed in 33% and nephropathy in 9.3%. SBP variability was significantly associated with pre-proliferative or proliferative retinopathy (aOR 1.13, 95% CI 1.00–1.27) and proliferative retinopathy/ laser photocoagulation (1.23, 1.04–1.45), as well as with any albuminuria (1.15, 1.08–1.23) and macroalbuminuria (1.29, 1.15–1.45). DBP variability was associated with any albuminuria (1.11, 1.03–1.19) and macroalbuminuria (1.28, 1.10–1.50). HbA1c variability was associated with any retinopathy (1.14, 1.08–1.20) and any albuminuria (1.12, 1.03–1.21).</p> Conclusions <p>Beyond mean levels, higher variability in HbA1c and BP is associated with retinopathy and nephropathy. Stable BP control in patients with established retinopathy may be important to prevent progression to sight-threatening stages.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Retinopathy and nephropathy in type 1 diabetes: role of HbA1c and blood pressure variability

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年9月17日

查看全文
  • Pavel Fatulla,
  • Johnny Ludvigsson,
  • Henrik Imberg,
  • Thomas Nyström,
  • Marcus Lind

摘要

Aims

To examine the association between within-person variability in glycated hemoglobin A1c (HbA1c) and blood pressure (BP) with retinopathy and nephropathy in type 1 diabetes (T1D).

Methods

This nationwide cohort included 9,358 individuals from the Swedish National Diabetes Register with T1D <5 years at inclusion (1998–2017) and ≥8 years follow-up. Variability in HbA1c, systolic BP (SBP), and diastolic BP (DBP) was calculated as updated SDs. Associations with microvascular complications were analyzed using logistic regression with generalized estimating equations, adjusted for demographic and clinical covariates.

Results

Mean age at inclusion was 14.2 years, mean diabetes duration 1.2 years, and 44% were female. Over 10.7 years’ follow-up, retinopathy developed in 33% and nephropathy in 9.3%. SBP variability was significantly associated with pre-proliferative or proliferative retinopathy (aOR 1.13, 95% CI 1.00–1.27) and proliferative retinopathy/ laser photocoagulation (1.23, 1.04–1.45), as well as with any albuminuria (1.15, 1.08–1.23) and macroalbuminuria (1.29, 1.15–1.45). DBP variability was associated with any albuminuria (1.11, 1.03–1.19) and macroalbuminuria (1.28, 1.10–1.50). HbA1c variability was associated with any retinopathy (1.14, 1.08–1.20) and any albuminuria (1.12, 1.03–1.21).

Conclusions

Beyond mean levels, higher variability in HbA1c and BP is associated with retinopathy and nephropathy. Stable BP control in patients with established retinopathy may be important to prevent progression to sight-threatening stages.