title: Risk of future microvascular and macrovascular disease in people with Type 1 diabetes of very long duration: a national study with 10-year follow-up.
abstract: To describe factors associated with prevalence or absence of microvascular and macrovascular complications in people with Type 1 diabetes of very long duration and to investigate the risk factors associated with the incidence of such complications.
  
  
  
  We included individuals with Type 1 diabetes who had been entered in the Swedish National Diabetes Register between 2002 and 2004 (n = 18 450). First, risk factor distribution in people with diabetes duration of ≥ 50 years was compared between people with and without complications. Second, the incidence of complications during a 10-year follow-up period was studied in all individuals who had no complications at baseline.
  
  
  
  Among people with a diabetes duration of ≥ 50 years (n = 1023), 453 (44%) had macrovascular disease, 534 (52%) had microvascular disease and 319 (31%) did not have either of the diagnoses. Factors that differed significantly between people with and without macrovascular disease were gender, age, HbA1c, BMI, LDL cholesterol, HDL cholesterol, triglycerides, systolic blood pressure, albuminuria, antihypertensive medication and lipid-lowering medication. The same factors differed significantly between people with and without microvascular disease, with the exception of gender and HDL cholesterol. During the follow-up period, 6.1% of the study cohort were diagnosed with macrovascular disease and 19.6% with microvascular disease. Incidence of macrovascular disease was significantly associated with HbA1clevels. Hazard ratios decreased with longer diabetes duration.
  
  
  
  People with Type 1 diabetes who have survived ≥ 50 years without complications are significantly younger, and have significantly lower HbA1clevels, BMI and triglyceride levels than survivors with complications. HbA1clevel is a predictor of macrovascular disease, independently of diabetes duration.
authors.affiliation: National Diabetes Register, Centre of Registers Västra Götaland, Gothenburg, Sweden.|Department of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Adamsson Eryd
authors.affiliation: National Diabetes Register, Centre of Registers Västra Götaland, Gothenburg, Sweden.
authors.forename: A-M
authors.initials: AM
authors.lastname: Svensson
authors.affiliation: National Diabetes Register, Centre of Registers Västra Götaland, Gothenburg, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Franzén
authors.affiliation: Department of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Eliasson
authors.affiliation: Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden.
authors.forename: P M
authors.initials: PM
authors.lastname: Nilsson
authors.affiliation: National Diabetes Register, Centre of Registers Västra Götaland, Gothenburg, Sweden.|Department of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Gudbjörnsdottir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D015994:Incidence; D008297:Male; D055806:Microvessels / Q000503:physiopathology; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human