Therapy, glycaemic control and complications in type 1 diabetic patients: Results from a single centre cohort of 465 subjects

We analysed the clinical characteristics, the degree of glycaemic control a nd the prevalence of complications in 465 type 1 diabetic adult patients (2 32 males), in view of current recommendations for metabolic and blood press ure control. Age and diabetes duration were 45 +/- 17 and 20 +/- 13 years r espectively (mean +/-1 SD). Daily insulin dose was 0.65 +/-0.24 U/kg b.w. 7 3% of patients received greater than or equal to3 injections/day, while 11% had continuous subcutaneous insulin infusion. All were practizing home blo od glucose monitoring. Current HbA(1)c was 8.5% [7.7-9.3%] (median [percent iles 25-75]). There was no difference in HbA(1)c according to number of inj ections or CSII use. When patients were divided according to HbA(1)c quinti les, significantly lower prevalences of retinopathy and neuropathy were fou nd in quintile 1 individuals. A mean of 53 severe, hypoglycaemic episodes w as reported per 100 patients/year, and they were more frequent in subjects exhibiting better glycaemic control. High blood pressure levels were found in 27% of subjects according to JNC-VI criteria. Fasting cholesterol (C), L DL-C, HDL-C and triglycerides were within normal range. However, according to current guidelines emphasizing on lower target thresholds, up to 27% of patients exhibited some degree of dyslipidaemia, in particular LDL-C higher than 3.3 mmol/l. In conclusion, in this large cohort of type 1 diabetic patients regularly a ttending a University Centre, overall glycaemic control remains above the s atisfactory levels inferred from optimization studies. Although mean blood pressure and blood lipids were up to recently deemed adequate, a (too) high proportion of diabetic patients exhibited either hypertension and/or dysli pidaemia according to revised therapeutic goals cut-offs.