Incidence of and risk factors for hospitalisations due to vascular complications: A population-based type 1 diabetes cohort (n = 1316) followed into early adulthood

Research suggests that as many as 60% of people with type 1 diabetes (T1D) admit to misusing insulin. Insulin omission (IO) for the purpose of weight loss, often referred to as diabulimia, is a behaviour becoming increasingly recognised, not least since prolonged engagement can lead to serious vascular complications and mortality. Several risk factors appear to be relevant to the development of IO, most notably gender, anxiety and depression and increased weight concerns and body dissatisfaction. Evidence suggests that women, especially young girls, are more likely to omit insulin as a method of weight loss compared to men. Mental health conditions such as anxiety and depression are increasingly prevalent in people with T1D compared to their peers, and appear to contribute to the risk of IO. Increased weight concerns and body dissatisfaction are further prominent risk factors, especially given increases in weight which often occur following diagnosis and the monitoring of weight by diabetes teams. This review presents evidence examining these risk factors which increase the likelihood of a person with T1D engaging in IO and highlights the complications associated with prolongment of the behaviour. Further research looking at the comorbidities of these risk factors, alongside other factors, would provide greater insight into understanding IO in people with T1D.

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Perinatal and childhood risk factors for early-onset type 1 diabetes: a population-based case-control study in Taiwan

European Journal of Public Health ◽

10.1093/eurpub/ckv059 ◽

2015 ◽

Vol 25 (6) ◽

pp. 1024-1029 ◽

Cited By ~ 11

Author(s):

Hsin-Yu Lee ◽

Chin-Li Lu ◽

Hua-Fen Chen ◽

Hui-Fang Su ◽

Chung-Yi Li

Keyword(s):

Risk Factors ◽

Type 1 Diabetes ◽

Early Onset ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Onset Type ◽

Childhood Risk Factors ◽

Control Study

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Cohort profile: the Funen Diabetes Database—a population-based cohort of patients with diabetes in Denmark

BMJ Open ◽

10.1136/bmjopen-2019-035492 ◽

2020 ◽

Vol 10 (4) ◽

pp. e035492

Author(s):

Kasper Adelborg ◽

Péter Szentkúti ◽

Jan Erik Henriksen ◽

Reimar Wernich Thomsen ◽

Lars Pedersen ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Geographical Area ◽

Population Based ◽

Haemoglobin A1c ◽

Patients With Diabetes

PurposeDetailed population-based data are essential to understanding the epidemiology of diabetes and its clinical course. This article describes the Funen Diabetes Database (FDDB). The purpose of the FDDB was to serve as a shared electronic medical record system for healthcare professionals treating patients with diabetes. The cohort can also be used for research.ParticipantsThe FDDB covers a geographical area of almost 500 000 Danish inhabitants. It currently includes 3691 patients with type 1 diabetes, 19 085 patients with type 2 diabetes, 292 patients with other types of diabetes and 5992 patients with an unknown type of diabetes. Patients have been continuously enrolled from general practitioners and endocrinology departments in the Funen area in Denmark since 2003. Patients undergo a clinical work-up at their first diabetes contact and during follow-up visits. The information collected includes type of diabetes contact, blood pressure, height, weight, lifestyle factors (smoking, exercise), laboratory records (eg, haemoglobin A1c and cholesterol levels), results from foot examinations (eg, pulse, cutaneous sensitivity and ankle brachial index), results from eye examinations (eg, degree of retinopathy assessed by retinal photo and eye examination), glucose-lowering drugs and diabetic complications.Findings to dateThe FDDB cohort was followed for a total of 212 234 person-years up to 2016. A cross-sectional study described the prevalence of diabetic retinopathy and its associated risk factors. The clinical outcomes of patients with type 1 diabetes, type 2 diabetes and latent autoimmune diabetes in adults have been assessed. Linkage to population-based medical registries with complete follow-up has enabled the collection of extensive continuous data on general practice contacts, diagnoses and procedures from hospital contacts, medication use and mortality.Future plansThe FDDB serves as a strong data resource that will be used in future studies of diabetes epidemiology with focus on occurrence, risk factors, treatment, complications and prognosis.

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