Incidence of diabetes-related complications in Chinese patients with type 1 diabetes: A population-based longitudinal cohort study in Taiwan

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Abstract

Objective To estimate the incidence densities and cumulative incidence of diabetes-related complications in patients with type 1 diabetes for a maximum of 15-year follow-up. The estimations were further stratified by gender and age at diagnosis (ie, early onset: 0-12 years, late onset:≥13 years). Design A population-based retrospective longitudinal cohort study. Setting Taiwan's National Health Insurance medical claims. Participants 4007 patients newly diagnosed with type 1 diabetes were identified during 1999-2012. Outcome measures Acute complications included diabetic ketoacidosis (DKA) and hypoglycaemia. Chronic complications were cardiovascular diseases (CVD), retinopathy, neuropathy and nephropathy. Results The incidence density of retinopathy was greatest (97.74 per 1000 person-years), followed by those of nephropathy (31.36), neuropathy (23.93) and CVD (4.39). Among acute complications, the incidence density of DKA was greatest (121.11 per 1000 person-years). The cumulative incidences of acute complications after 12 years following diagnosis were estimated to be 52.1%, 36.1% and 4.1% for DKA, outpatient hypoglycaemia and hospitalised hypoglycaemia, respectively. For chronic complications, the cumulative incidence of retinopathy after 12 years following diagnosis was greatest (65.2%), followed by those of nephropathy (30.2%), neuropathy (23.7%) and CVD (4.1%). Females with late-onset diabetes were greatly affected by advanced retinopathy (ie, sight-threatening diabetic retinopathy) and hospitalised hypoglycaemia, whereas those with early-onset diabetes were more vulnerable to DKA. Chronic complications were more commonly seen in late-onset diabetes, whereas early-onset diabetes were most affected by acute complications. Conclusions Ethnic Chinese patients with type 1 diabetes were greatly affected by DKA and retinopathy. The incidence of diabetes-related complications differed by age at diagnosis and sex.

Original languageEnglish
Article numbere015117
JournalBMJ open
Volume7
Issue number6
DOIs
Publication statusPublished - 2017 Jun 1

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Diabetes Complications
Type 1 Diabetes Mellitus
Taiwan
Diabetic Ketoacidosis
Longitudinal Studies
Cohort Studies
Hypoglycemia
Incidence
Population
Cardiovascular Diseases
Diabetic Retinopathy
National Health Programs
Outpatients
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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@article{8f27fa1574984aa6a9696ac340f69cff,
title = "Incidence of diabetes-related complications in Chinese patients with type 1 diabetes: A population-based longitudinal cohort study in Taiwan",
abstract = "Objective To estimate the incidence densities and cumulative incidence of diabetes-related complications in patients with type 1 diabetes for a maximum of 15-year follow-up. The estimations were further stratified by gender and age at diagnosis (ie, early onset: 0-12 years, late onset:≥13 years). Design A population-based retrospective longitudinal cohort study. Setting Taiwan's National Health Insurance medical claims. Participants 4007 patients newly diagnosed with type 1 diabetes were identified during 1999-2012. Outcome measures Acute complications included diabetic ketoacidosis (DKA) and hypoglycaemia. Chronic complications were cardiovascular diseases (CVD), retinopathy, neuropathy and nephropathy. Results The incidence density of retinopathy was greatest (97.74 per 1000 person-years), followed by those of nephropathy (31.36), neuropathy (23.93) and CVD (4.39). Among acute complications, the incidence density of DKA was greatest (121.11 per 1000 person-years). The cumulative incidences of acute complications after 12 years following diagnosis were estimated to be 52.1{\%}, 36.1{\%} and 4.1{\%} for DKA, outpatient hypoglycaemia and hospitalised hypoglycaemia, respectively. For chronic complications, the cumulative incidence of retinopathy after 12 years following diagnosis was greatest (65.2{\%}), followed by those of nephropathy (30.2{\%}), neuropathy (23.7{\%}) and CVD (4.1{\%}). Females with late-onset diabetes were greatly affected by advanced retinopathy (ie, sight-threatening diabetic retinopathy) and hospitalised hypoglycaemia, whereas those with early-onset diabetes were more vulnerable to DKA. Chronic complications were more commonly seen in late-onset diabetes, whereas early-onset diabetes were most affected by acute complications. Conclusions Ethnic Chinese patients with type 1 diabetes were greatly affected by DKA and retinopathy. The incidence of diabetes-related complications differed by age at diagnosis and sex.",
author = "Ou, {Huang Tz} and Lee, {Tsung Ying} and Li, {Chung Yi} and Wu, {Jin Shang} and Sun, {Zih Jie}",
year = "2017",
month = "6",
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doi = "10.1136/bmjopen-2016-015117",
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TY - JOUR

T1 - Incidence of diabetes-related complications in Chinese patients with type 1 diabetes

T2 - A population-based longitudinal cohort study in Taiwan

AU - Ou, Huang Tz

AU - Lee, Tsung Ying

AU - Li, Chung Yi

AU - Wu, Jin Shang

AU - Sun, Zih Jie

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Objective To estimate the incidence densities and cumulative incidence of diabetes-related complications in patients with type 1 diabetes for a maximum of 15-year follow-up. The estimations were further stratified by gender and age at diagnosis (ie, early onset: 0-12 years, late onset:≥13 years). Design A population-based retrospective longitudinal cohort study. Setting Taiwan's National Health Insurance medical claims. Participants 4007 patients newly diagnosed with type 1 diabetes were identified during 1999-2012. Outcome measures Acute complications included diabetic ketoacidosis (DKA) and hypoglycaemia. Chronic complications were cardiovascular diseases (CVD), retinopathy, neuropathy and nephropathy. Results The incidence density of retinopathy was greatest (97.74 per 1000 person-years), followed by those of nephropathy (31.36), neuropathy (23.93) and CVD (4.39). Among acute complications, the incidence density of DKA was greatest (121.11 per 1000 person-years). The cumulative incidences of acute complications after 12 years following diagnosis were estimated to be 52.1%, 36.1% and 4.1% for DKA, outpatient hypoglycaemia and hospitalised hypoglycaemia, respectively. For chronic complications, the cumulative incidence of retinopathy after 12 years following diagnosis was greatest (65.2%), followed by those of nephropathy (30.2%), neuropathy (23.7%) and CVD (4.1%). Females with late-onset diabetes were greatly affected by advanced retinopathy (ie, sight-threatening diabetic retinopathy) and hospitalised hypoglycaemia, whereas those with early-onset diabetes were more vulnerable to DKA. Chronic complications were more commonly seen in late-onset diabetes, whereas early-onset diabetes were most affected by acute complications. Conclusions Ethnic Chinese patients with type 1 diabetes were greatly affected by DKA and retinopathy. The incidence of diabetes-related complications differed by age at diagnosis and sex.

AB - Objective To estimate the incidence densities and cumulative incidence of diabetes-related complications in patients with type 1 diabetes for a maximum of 15-year follow-up. The estimations were further stratified by gender and age at diagnosis (ie, early onset: 0-12 years, late onset:≥13 years). Design A population-based retrospective longitudinal cohort study. Setting Taiwan's National Health Insurance medical claims. Participants 4007 patients newly diagnosed with type 1 diabetes were identified during 1999-2012. Outcome measures Acute complications included diabetic ketoacidosis (DKA) and hypoglycaemia. Chronic complications were cardiovascular diseases (CVD), retinopathy, neuropathy and nephropathy. Results The incidence density of retinopathy was greatest (97.74 per 1000 person-years), followed by those of nephropathy (31.36), neuropathy (23.93) and CVD (4.39). Among acute complications, the incidence density of DKA was greatest (121.11 per 1000 person-years). The cumulative incidences of acute complications after 12 years following diagnosis were estimated to be 52.1%, 36.1% and 4.1% for DKA, outpatient hypoglycaemia and hospitalised hypoglycaemia, respectively. For chronic complications, the cumulative incidence of retinopathy after 12 years following diagnosis was greatest (65.2%), followed by those of nephropathy (30.2%), neuropathy (23.7%) and CVD (4.1%). Females with late-onset diabetes were greatly affected by advanced retinopathy (ie, sight-threatening diabetic retinopathy) and hospitalised hypoglycaemia, whereas those with early-onset diabetes were more vulnerable to DKA. Chronic complications were more commonly seen in late-onset diabetes, whereas early-onset diabetes were most affected by acute complications. Conclusions Ethnic Chinese patients with type 1 diabetes were greatly affected by DKA and retinopathy. The incidence of diabetes-related complications differed by age at diagnosis and sex.

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U2 - 10.1136/bmjopen-2016-015117

DO - 10.1136/bmjopen-2016-015117

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VL - 7

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

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