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Metabolic syndrome in type 1 diabetes and its association with diabetes complications
Author(s) -
Lee Angela S.,
Twigg S. M.,
Flack J. R.
Publication year - 2021
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.14376
Subject(s) - medicine , metabolic syndrome , diabetes mellitus , type 2 diabetes , cohort , odds ratio , cross sectional study , metformin , cohort study , pediatrics , endocrinology , pathology
Aim To assess the prevalence of metabolic syndrome in type 1 diabetes, and its age‐related association with diabetes complications. Methods Australian National Diabetes Information Audit and Benchmarking (ANDIAB) was a well‐established quality audit programme. It provided cross‐sectional data on people attending specialist diabetes services across Australia. We determined the prevalence of metabolic syndrome (WHO criteria) in adults with type 1 diabetes and its associations with diabetes complications across age groups. Results Metabolic syndrome prevalence was 30% in 2120 adults with type 1 diabetes. Prevalence increased with age: 21% in those aged <40 years, 35% in those aged 40–60 years, and 44% in those aged >60 years ( P <0.001), which was driven by an increase in hypertension rate. Metabolic syndrome was associated with a higher prevalence of microvascular, macrovascular and foot complications, with the greatest impact at a younger age. The odds ratio for macrovascular complications with metabolic syndrome, compared with without, was 5.9 (95% CI 2.1–16.4) in people aged <40 years, 2.7 (95% CI 1.7–4.2) in those aged 40–60 years, and 1.7 (95% CI 1.1–2.7) in those aged >60 years (all P < 0.05). Metformin use was higher in those with metabolic syndrome (16% vs 4%; P <0.001). Conclusions In this large Australian cohort, metabolic syndrome was common in type 1 diabetes and identified people at increased risk of the spectrum of diabetes complications, particularly in young to middle‐aged adults. Potential clinical implications are that therapies targeting insulin resistance in this high‐risk group may reduce diabetes complications and should be explored.