Ilze Salna1, Edgars Salna2, Leonora Pahirko3, Sabīne Skrebinska4, Regīna Krikova2, Inese Folkmane5, Valdis Pīrāgs1, Jelizaveta Sokolovska6. 1. University of Latvia, Faculty of Medicine, Jelgavas iela 3, LV 1004 Riga, Latvia; Pauls Stradiņš Clinical University Hospital, Endocrinology Department, Pilsoņu iela 13, LV 1002 Riga, Latvia. 2. University of Latvia, Faculty of Medicine, Jelgavas iela 3, LV 1004 Riga, Latvia. 3. University of Latvia, Faculty of Physics, Mathematics and Optometry, Jelgavas iela 3, LV 1004 Riga, Latvia. 4. Riga Stradiņš University, Faculty of Residency, Dzirciema iela 16, LV 1007 Riga, Latvia. 5. University of Latvia, Faculty of Medicine, Jelgavas iela 3, LV 1004 Riga, Latvia; Pauls Stradiņš Clinical University Hospital, Centre of Nephrology, Pilsoņu iela 13, LV 1002 Riga, Latvia. 6. University of Latvia, Faculty of Medicine, Jelgavas iela 3, LV 1004 Riga, Latvia. Electronic address: jelizaveta.sokolovska@lu.lv.
Abstract
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.
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.
Authors: Lilian Tzivian; Jelizaveta Sokolovska; Anna E Grike; Agate Kalcenaua; Abraham Seidmann; Arriel Benis; Martins Mednis; Ieva Danovska; Ugis Berzins; Arnolds Bogdanovs; Emil Syundyukov Journal: Health Qual Life Outcomes Date: 2022-08-01 Impact factor: 3.077