The presence of microvascular complications is associated with a poor evolution of metabolic control in patients with type 1 diabetes mellitus

Objective: To report the evolution of metabolic control and to assess the clinical and metabolic factors associated with the presence of microvascular complications in patients with type 1 diabetes mellitus (T1DM). Material and methods: This was a retrospective, observational study analysing clinical, laboratory, and therapeutic data from a registry of patients with T1DM created in 2010. Results: Data recorded from 586 patients (males: 50.2%; mean age: 36.1 +/- 13.5 years; T1DM duration: 18.0 +/- 12.1 years) followed for a mean of 6.0 +/- 3.1 years were assessed, and 8,133 HbA1c levels (13.2 +/- 7.6 measurements/patient) were analysed, with a mean evolutionary HbA1c of 7.9% +/- 1.2%. The mean annual HbA1c level gradually improved from 8.6% +/- 1.6% in 2010 to 7.5% +/- 1.4% in 2019, with 34.3% and 69.0% of patients having HbA1c levels <7% and <8% respectively. Patients with T1DM duration of < 10 years and >20 years, non-smokers, CSII users, and those using the insulin/carbohydrate ratio had better current and evolutionary HbA1c levels. The presence of microvascular complications was independently associated with T1DM lasting > 20 years, the presence of HBP, and evolutionary HbA1c > 7.0%. Conclusion: A progressive but still inadequate improvement in metabolic control over 10 years was seen in patients with T1DM. Poor metabolic control (mean HbA1c over 10 years >7%) was independently associated with the presence of microvascular complications. (c) 2020 SEEN y SED. Published by Elsevier Espa & ntilde;a, S.L.U. All rights reserved.