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Background <p>To evaluate the real-world care of Brazilian individuals with type 1 diabetes (T1D).</p> Methods <p>The Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), was conducted in two waves, in all Brazilian geographical regions. The first enrolled 3,591 individuals with data obtained from medical records. The second evaluated 1,760 individuals with laboratory and genetic data performed at State University of Rio de Janeiro.</p> Results <p>In the first and second waves, the average HbA1c was 9.3% and 9.0%, HbA1c above 10%, 32.2% and 26.3%, and individuals with HbA1c &lt; 7.0%, 13.2% and 13.5%, respectively. Intermediate/long plus short acting insulins was the commonest used treatment modality. Less than 30% of the individuals achieved good glycemic control. Individuals in pumps and insulin analogs had lower mean HbA1c. Diabetic retinopathy, chronic kidney disease, cardiac autonomic neuropathy, peripheral neuropathy and macrovascular diseases were found in 35.7%; 25.2%; 23.4%; 14.8% and 2,1%, respectively. The 10-year Steno type 1 risk engine (S1TRE) showing moderate and high risk was noted in 18.0% and 11.3% of individuals. Diabetic retinopathy was associated with all diabetes-related chronic complications. Severe hypoglycemia was reported by 19%, periodontal disease by 4. % and autoimmune diseases by 19.5% of individuals. European genomic ancestry prevailed in the whole sample even in those Black self-reported. HLA-DRB1*03:01 ~ DQA1*05:01 ~ DQB1*02:01 was the most frequent risk haplotype with the highest frequency in individuals who self-reported as White and the haplotype HLA-DRB1*09:01 ~ DQA1*03:01&#xa0;g ~ DQB1*02:02 had the highest frequency among those self-reported as Black. European genomic ancestry was associated with the risk alleles: DRB1*03:01; DRB1*04:01; DRB1*04:02; DQA1*05:01 DQB1*02:01; DQB1*03:02 and African genomic ancestry with the protective alleles: DRB1*03:02; DRB1*11:01; and DRB1*15:03. Amerindian (43.6%, haplogroup C) and African (38.2%, haplogroup L3) were the most frequent matrilineal ancestries (MtDNA). European patrilineal ancestry was predominant, in approximately 85%, followed by African ancestry in approximately 9%. European haplogroups R1b and E1b were the most prevalent.</p> Conclusions <p>In both waves, Brazilian individuals with T1D presented poor glycemic control and high rates of diabetes-related acute and chronic complications. Our data has been used to improve T1D management driving public health policies in Brazil.</p>

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Type 1 diabetes in Brazil: a narrative overview of the Brazilian Type 1 Diabetes Study Group

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  • 发表日期：

    2025年5月24日

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  • Marilia Brito Gomes,
  • Carlos Antonio Negrato,
  • Laura Nunes Melo,
  • Roberta Cobas,
  • Lucianne Righet Monteiro Tannus,
  • Jose Egídio Paulo de Oliveira,
  • Melanie Rodacki,
  • Lenita Zajdenverg,
  • Joana Rodrigues Dantas,
  • Maria Lúcia Cardillo Corrêa-Giannella,
  • Marcia Nery,
  • Sharon Nina Admoni,
  • Daniele Pereira dos Santos,
  • Maria de Fatima Guedes,
  • Sergio Atala Dib,
  • Patricia Dualib,
  • Celso Ferreira de Camargo Sallum Filho,
  • Paulo Henrique Morales,
  • Fernando Malerbi,
  • Karla Guerra Drumond,
  • Elisabeth João Pavin,
  • Franz Schubert Leal,
  • Caroline Takano,
  • Rosângela Roginski Rea,
  • Ana Cristina Ravazzani de Almeida Faria,
  • Nicole Balster Romanzini,
  • Mirela Azevedo,
  • Luis Henrique Canani,
  • Felipe Mallmann,
  • Hermelinda Cordeiro Pedrosa,
  • Monica Tolentino,
  • Cejana Hamu Aguiar,
  • André Pinheiro,
  • Reine Marie Chaves Fonseca,
  • Ludmila Chaves Fonseca,
  • Tessa Mattos,
  • Raffaele Kasprowicz,
  • Adriana Costa e Forti,
  • Angela Delmira Nunes Mendes,
  • Renan Montenegro Junior,
  • Ana Paula Montenegro,
  • Virgínia Oliveira Fernandes,
  • João Soares Felício,
  • Flavia Marques Santos,
  • Alberto Ramos,
  • Antonio Carlos Pires,
  • Balduino Tschiedel,
  • Suzana Lavigne,
  • Deborah Laredo Jezini,
  • Marisa Coral,
  • Janice Sepulveda,
  • Saulo Cavalcanti da Silva,
  • Neuza Braga Campos de Araújo,
  • Luiz Calliari,
  • Luis Antonio de Araújo,
  • Cristina Façanha,
  • Nelson Rassi,
  • Rossana Azulay,
  • Manuel Faria,
  • Emerson Sampaio,
  • Henriqueta Guidio de Almeida,
  • Jorge Luiz Luescher,
  • Renata Szundy Berardo,
  • Thais Della Manna,
  • Milton Cesar Foss,
  • Maria Cristina Foss,
  • Roberta Salvodelli,
  • Luis Cristovão Porto,
  • Dayse Silva,
  • Livia Ferreira,
  • Naira Horta Melo,
  • Karla Freire Rezende

摘要

Background

To evaluate the real-world care of Brazilian individuals with type 1 diabetes (T1D).

Methods

The Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), was conducted in two waves, in all Brazilian geographical regions. The first enrolled 3,591 individuals with data obtained from medical records. The second evaluated 1,760 individuals with laboratory and genetic data performed at State University of Rio de Janeiro.

Results

In the first and second waves, the average HbA1c was 9.3% and 9.0%, HbA1c above 10%, 32.2% and 26.3%, and individuals with HbA1c < 7.0%, 13.2% and 13.5%, respectively. Intermediate/long plus short acting insulins was the commonest used treatment modality. Less than 30% of the individuals achieved good glycemic control. Individuals in pumps and insulin analogs had lower mean HbA1c. Diabetic retinopathy, chronic kidney disease, cardiac autonomic neuropathy, peripheral neuropathy and macrovascular diseases were found in 35.7%; 25.2%; 23.4%; 14.8% and 2,1%, respectively. The 10-year Steno type 1 risk engine (S1TRE) showing moderate and high risk was noted in 18.0% and 11.3% of individuals. Diabetic retinopathy was associated with all diabetes-related chronic complications. Severe hypoglycemia was reported by 19%, periodontal disease by 4. % and autoimmune diseases by 19.5% of individuals. European genomic ancestry prevailed in the whole sample even in those Black self-reported. HLA-DRB1*03:01 ~ DQA1*05:01 ~ DQB1*02:01 was the most frequent risk haplotype with the highest frequency in individuals who self-reported as White and the haplotype HLA-DRB1*09:01 ~ DQA1*03:01 g ~ DQB1*02:02 had the highest frequency among those self-reported as Black. European genomic ancestry was associated with the risk alleles: DRB1*03:01; DRB1*04:01; DRB1*04:02; DQA1*05:01 DQB1*02:01; DQB1*03:02 and African genomic ancestry with the protective alleles: DRB1*03:02; DRB1*11:01; and DRB1*15:03. Amerindian (43.6%, haplogroup C) and African (38.2%, haplogroup L3) were the most frequent matrilineal ancestries (MtDNA). European patrilineal ancestry was predominant, in approximately 85%, followed by African ancestry in approximately 9%. European haplogroups R1b and E1b were the most prevalent.

Conclusions

In both waves, Brazilian individuals with T1D presented poor glycemic control and high rates of diabetes-related acute and chronic complications. Our data has been used to improve T1D management driving public health policies in Brazil.