title: Clinical status of a cohort of patients with type 1 diabetes diagnosed more than 2 decades before. Results of a specific clinical follow-up program.
abstract: OBJECTIVE
  The clinical course of type 1 diabetes mellitus (T1DM) has changed in recent decades. The aim of our study was to assess the long-term (> 20 years) clinical status of a patient cohort with T1DM under a specific treatment and follow-up program.
  
  
  METHODS
  A single center, observational, cross-sectional study was conducted of a patient cohort diagnosed with T1DM in the 1986-1994 period at our tertiary university hospital. Clinical characteristics, metabolic parameters, and occurrence of chronic complications and comorbidities after > 20 years of follow-up were collected. All subjects entered our specific program for patients with newly-diagnosed T1D and were followed up using the same clinical protocol. Data are shown as mean (standard deviation) or as number of patients and percentage. The appropriate test was used to compare quantitative and qualitative data. A P value <0.05 was considered statistically significant.
  
  
  RESULTS
  A total of 279 patients were recorded, of whom 153 (53.6% women; mean age 46.6±8.6 years; age at onset 23.3±8.8 years; disease duration, 23.3±2.6 years) continued to attend our diabetes unit at the time of the analysis. Of these patients, 24.8% were administered continuous subcutaneous insulin infusion (CSII). Mean HbA1c in the past 5 years and in the last year were7.8±0.9% and 7.7±1.1% respectively (7.3±1.5% in those given CSII). Smoking was reported by 19.6% of patients, while 15.7% had high blood pressure and 37.9% dyslipidemia. Diabetic retinopathy was diagnosed in 20.4%, and 11.3% of the total cohort had nephropathy. Only 1.3% of our patients had a history of CVD.
  
  
  CONCLUSIONS
  Data collected from a cohort of patients with T1DM for more than 2 decades regularly followed up with a specific program in a tertiary university hospital suggest a remarkably low prevalence of diabetic complications.
authors.affiliation: Unidad de Diabetes, Servicio de Endocrinología y Nutrición, ICMDiM (Institut de Malalties Digestives i Metabòliques), Hospital Clínic i Universitari de Barcelona. IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, España.
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Amor
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Universitari Son Espases, Palma de Mallorca, España.
authors.forename: Maria
authors.initials: M
authors.lastname: Cabrer
authors.affiliation: Unidad de Diabetes, Servicio de Endocrinología y Nutrición, ICMDiM (Institut de Malalties Digestives i Metabòliques), Hospital Clínic i Universitari de Barcelona. IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, España.
authors.forename: Marga
authors.initials: M
authors.lastname: Giménez
authors.affiliation: Unidad de Diabetes, Servicio de Endocrinología y Nutrición, ICMDiM (Institut de Malalties Digestives i Metabòliques), Hospital Clínic i Universitari de Barcelona. IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, España.
authors.forename: Irene
authors.initials: I
authors.lastname: Vinagre
authors.affiliation: Unidad de Diabetes, Servicio de Endocrinología y Nutrición, ICMDiM (Institut de Malalties Digestives i Metabòliques), Hospital Clínic i Universitari de Barcelona. IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, España.
authors.forename: Emilio
authors.initials: E
authors.lastname: Ortega
authors.affiliation: Unidad de Diabetes, Servicio de Endocrinología y Nutrición, ICMDiM (Institut de Malalties Digestives i Metabòliques), Hospital Clínic i Universitari de Barcelona. IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, España. Electronic address: iconget@clinic.ub.es.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Conget
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000453:epidemiology*; D019468:Disease Management; D042241:Early Diagnosis; D057286:Electronic Health Records; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D015397:Program Evaluation; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D000960:Hypolipidemic Agents; D007328:Insulin
keywords: Cardiovascular disease; Complicaciones microvasculares; Diabetes tipo 1; Enfermedad cardiovascular; Microvascular complications; Type 1 diabetes mellitus