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Model to forecast type 1 diabetes outcomes could improve daily practice, clinical trials
Researchers in the Netherlands have developed a model using prognostic criteria that could provide a means for determining severe outcomes for patients with type 1 diabetes, according to research published in Diabetologia.
Routinely-measured risk factors compiled into a program by Sabita S. Soedamah-Muthu, PhD, of the Division of Human Nutrition, Wageningen University, and colleagues from other institutions, could help in daily practice and risk stratification for research.
“We present a new prognostic model combining information on age, glycated hemoglobin, waist-hip ratio, albumin to creatinine ratio and HDL-cholesterol to assess the 3-, 5- and 7-year risk of developing major outcomes in patients with type 1 diabetes,” Soedamah-Muthu told Endocrine Today.
The investigators analyzed 1,973 patients (mean age, 30.3 years) with type 1 diabetes (mean duration, 11.5 years) who had participated in the EURODIAB Prospective Complications Study. The team combined prognostic factors for severe outcomes into a Weibull regression model. Based on 7 years of follow-up data, 95 EURODIAB patients had developed major outcomes.
The researchers tested the model’s performance in three prospective cohorts: the Pittsburgh Epidemiology of Diabetes Complications study (EDC, n=554), the Finnish Diabetic Nephropathy study (FinnDiane, n=2,999) and the Coronary Artery Calcification in Type 1 Diabetes study (CACTI, n=580).
The discriminative ability was found to be adequate, with a concordance statistic of 0.74. Concordance statistics were similar or better for EDC (0.79), FinnDiane (0.82) and CACTI (0.73).
“We provide a clinical tool to automatically assess the risk of developing major outcomes combining severe coronary heart disease, stroke, end stage renal failure, amputations, blindness and all-cause mortality in patients with type 1 diabetes,” Soedamah-Muthu said. “This tool can aid physicians and patients to identify those at highest risk and focus the intervention following existing guidelines. It can also help to select high-risk populations for randomized controlled trials.” — by Allegra Tiver
Disclosures: Please see study for full list of disclosures.