Metabolic syndrome in type 1 diabetes and its association with diabetes complications

• Published in: Diabetic medicine Vol. 38; no. 2; pp. e14376 - n/a
• Main Authors: Lee, Angela S., Twigg, S. M., Flack, J. R.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-02-2021
• Subjects: Adult; Age; Age Distribution; Albuminuria - epidemiology; Amputation - statistics & numerical data; Diabetes; Diabetes Complications - epidemiology; Diabetes Complications - etiology; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - epidemiology; Diabetic Foot - epidemiology; Diabetic Foot - etiology; Diabetic Nephropathies - epidemiology; Diabetic Nephropathies - etiology; Diabetic Neuropathies - epidemiology; Diabetic Neuropathies - etiology; Diabetic Retinopathy - epidemiology; Diabetic Retinopathy - etiology; Dietary fiber; Dyslipidemias - epidemiology; Female; Humans; Hypertension - epidemiology; Insulin; Insulin resistance; Kidney Failure, Chronic - epidemiology; Kidney Failure, Chronic - etiology; Male; Metabolic syndrome; Metabolic Syndrome - epidemiology; Metformin; Microvasculature; Middle Aged; Myocardial Infarction - epidemiology; Myocardial Infarction - etiology; Myocardial Revascularization - statistics & numerical data; Obesity - epidemiology; Peripheral Vascular Diseases - epidemiology; Peripheral Vascular Diseases - etiology; Prevalence; Stroke - epidemiology; Stroke - etiology
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/dme.14376

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.