Background: Optimal diabetes care and risk factor management are important to delay micro- and macrovascular complications in individuals with type 1 diabetes (T1D) . Ongoing improvement of management strategies requires the evaluation of target achievement and identification of determinants in individuals who do (or do not) achieve these targets.
Methods: Cross-sectional data were collected from individuals with T1D visiting Diabeter and the University Medical Center Groningen, the Netherlands, in 2018. Targets were defined as HbA1c <7%, LDL-c <2.6mmol/l (no CVD present) or <1.8mmol/l (CVD present) , or blood pressure (BP) <140/90mmHg. Determinants between individuals who did (or did not) achieve targets were compared by presence of CVD.
Results: Data from 1,737 individuals were available. Mean age was 27 [IQR 22-43] years and 50% female. Mean HbA1c was 63 mmol/mol (7.9%) , LDL-c was 2.67mmol/l, and BP 131/76mmHg. In individuals with CVD, 24%, 33%, and 46% achieved HbA1c, LDL-c, and BP targets respectively. In individuals without CVD these percentages were, 29%, 54%, and 77%, respectively. Individuals with CVD who did or did not achieve HbA1c targets did not differ significantly. Individuals who achieved LDL-c targets had a longer diabetes duration (42 vs. 37 years, p=0.03) , lower eGFR (eGFR 56 vs. 70 ml/min/kg2) and were prescribed more lipid lowering medication (94% vs. 77%, p=0.05) . Individuals who achieved BP targets were younger (58 vs. 62 years, p=0.05) . In comparison, individuals without CVD who achieved HbA1c targets differed in age (28 vs. 25 years, p=<.001) , sex (45% vs. 53% female, p=0.02) , and insulin pump use (60% vs 52%, p=0.01) amongst others. Those who achieved LDL-c targets had lower BMI (24.1 vs. 26.1kg/m2, p=<.001) . BP targets were achieved by younger individuals with less microvascular complications (14% vs. 33%, p=<.001) .
Conclusions: Opportunities for improvement diabetes management exist for the achievement of glycaemic, lipid and BP targets but differ between individuals with and without CVD.
R.D.M.Varkevisser: None. E.Birnie: None. C.E.Vollenbrock: None. D.Mul: None. P.Van dijk: None. M.M.Van der klauw: Advisory Panel; Pfizer Inc. H.J.Veeze: Employee; Medtronic. H.Aanstoot: Consultant; Lilly Diabetes, Medtronic. B.H.Wolffenbuttel: Advisory Panel; Novo Nordisk A/S, Other Relationship; Novo Nordisk.