1120-P: Sex Differences in the Burden of Diabetes-Related Complications among Older Adults with Type 1 Diabetes

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 1120-P
Author(s):  
MARY ELIZABETH L. LEIGH ◽  
PAOLA GILSANZ ◽  
CHRIS MORAN ◽  
ANDREW J. KARTER ◽  
RACHEL A. WHITMER
Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 560-P
Author(s):  
NANCY CARDINEZ ◽  
LEIF ERIK LOVBLOM ◽  
JOHNNY-WEI BAI ◽  
ALON ABRAHAM ◽  
EVAN J. LEWIS ◽  
...  

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1544-P ◽  
Author(s):  
ELENA TOSCHI ◽  
CHRISTINE SLYNE ◽  
ASTRID ATAKOV-CASTILLO ◽  
KAYLA SIFRE ◽  
ALYSSA B. DUFOUR ◽  
...  

2017 ◽  
Vol 41 (5) ◽  
pp. S63
Author(s):  
Daniel Scarr ◽  
Leif E. Lovblom ◽  
Nancy Cardinez ◽  
Andrej Orszag ◽  
Mohammed A. Farooqi ◽  
...  

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 147-OR
Author(s):  
ELENA TOSCHI ◽  
CHRISTINE SLYNE ◽  
ASTRID ATAKOV-CASTILLO ◽  
MEDHA MUNSHI

Author(s):  
Elena Toschi ◽  
Astrid Atakov-Castillo ◽  
Christine Slyne ◽  
Medha Munshi

BMJ ◽  
2018 ◽  
pp. k4247 ◽  
Author(s):  
Elizabeth R C Millett ◽  
Sanne A E Peters ◽  
Mark Woodward

AbstractObjectivesTo investigate sex differences in risk factors for incident myocardial infarction (MI) and whether they vary with age.DesignProspective population based study.SettingUK Biobank.Participants471 998 participants (56% women; mean age 56.2) with no history of cardiovascular disease.Main outcome measureIncident (fatal and non-fatal) MI.Results5081 participants (1463 (28.8%) of whom were women) had MI over seven years’ mean follow-up, resulting in an incidence per 10 000 person years of 7.76 (95% confidence interval 7.37 to 8.16) for women and 24.35 (23.57 to 25.16) for men. Higher blood pressure indices, smoking intensity, body mass index, and the presence of diabetes were associated with an increased risk of MI in men and women, but associations were attenuated with age. In women, systolic blood pressure and hypertension, smoking status and intensity, and diabetes were associated with higher hazard ratios for MI compared with men: ratio of hazard ratios 1.09 (95% confidence interval 1.02 to 1.16) for systolic blood pressure, 1.55 (1.32 to 1.83) for current smoking, 2.91 (1.56 to 5.45) for type 1 diabetes, and 1.47 (1.16 to 1.87) for type 2 diabetes. There was no evidence that any of these ratios of hazard ratios decreased with age (P>0.2). With the exception of type 1 diabetes, the incidence of MI was higher in men than in women for all risk factors.ConclusionsAlthough the incidence of MI was higher in men than in women, several risk factors were more strongly associated with MI in women compared with men. Sex specific associations between risk factors and MI declined with age, but, where it occurred, the higher relative risk in women remained. As the population ages and the prevalence of lifestyle associated risk factors increase, the incidence of MI in women will likely become more similar to that in men.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Mary E Lacy ◽  
Paola Gilsanz ◽  
Chloe Eng ◽  
Michal S Beeri ◽  
Andrew J Karter ◽  
...  

Introduction: Studies have shown poorer cognitive function in children and adolescents with type 1 diabetes (T1D) as compared to non-diabetic peers. However, little is known about cognitive function in older adults with T1D. Hypothesis: We hypothesized that older adults with T1D and type 2 diabetes (T2D) would have greater cognitive impairment than age, sex, race/ethnicity, and education-matched controls without diabetes. Methods: We compared baseline cognitive impairment among older adults (aged ≥60) from the Study of Longevity in Diabetes (SOLID) with T1D (n=771), T2D (=234) and no diabetes (n=253). Cognitive tests assessed three cognitive domains identified via factor analysis (language, executive function, episodic memory). All cognitive test scores were standardized and cognitive impairment was defined as 1.5 SD below the mean. In logistic regression models adjusted for age, sex, education, and race/ethnicity, we examined the association between diabetes status (T1D, T2D or no diabetes) and cognition on each cognitive domain and on global cognition (average of scores on the 3 domains). Results: In adjusted regression models, compared to older adults without diabetes, those with T1D were more likely to have impaired cognitive function on the language (OR=2.13, 95% CI: 1.08, 4.17) and executive function domains (OR=2.66, 95% CI: 1.36, 5.22). No significant differences in global cognitive impairment or impairment on the episodic memory domain were observed for T1D and no significant differences on any domain were observed for T2D. Conclusions: Our findings suggest that older adults with T1D have greater cognitive impairment than their peers without diabetes; findings were specific to the language and executive function domains, with episodic memory being unaffected. No increase in cognitive impairment was observed for older adults with T2D. Additional research is needed to understand the causes and potentially modifiable factors associated with impaired cognition among older adults with T1D.


2020 ◽  
Vol 8 (1) ◽  
pp. e001173 ◽  
Author(s):  
Mary E Lacy ◽  
Paola Gilsanz ◽  
Chloe W Eng ◽  
Michal S Beeri ◽  
Andrew J Karter ◽  
...  

IntroductionDiabetic ketoacidosis (DKA) is a serious complication of diabetes. DKA is associated with poorer cognition in children with type 1 diabetes (T1D), but whether this is the case in older adults with T1D is unknown. Given the increasing life expectancy in T1D, understanding the role of DKA on brain health in older adults is crucial.Research design and methodsWe examined the association of DKA with cognitive function in 714 older adults with T1D from the Study of Longevity in Diabetes. Participants self-reported lifetime exposure to DKA resulting in hospitalization; DKA was categorized into 0 hospitalization, 1 hospitalization or ≥2 hospitalizations (recurrent DKA). Global and domain-specific cognition (language, executive function/psychomotor speed, episodic memory and simple attention) were assessed. The association of DKA with cognitive function was evaluated via linear and logistic regression models.ResultsTwenty-eight percent of participants (mean age=67 years; mean age at diagnosis=28 years; average duration of diabetes=39 years) reported a lifetime history of DKA resulting in hospitalization (18.5% single DKA; 9.7% recurrent DKA). In fully adjusted models, those with recurrent DKA had lower global cognitive function (β=−0.13; 95% CI −0.22 to 0.02) and lower scores on the executive function/psychomotor speed domain (β=−0.34; 95% CI −0.51 to 0.17). Individuals with recurrent DKA were also more likely to have the lowest level of cognitive function on the executive function/psychomotor speed domain (defined as 1.5 SD below the population mean; OR=3.26, 95% CI 1.43 to 7.42).ConclusionsAmong 714 older adults with T1D, recurrent DKA was associated with lower global cognitive function, lower scores on the executive function/psychomotor speed domain and 3.3 times greater risk of having the lowest level of cognitive function in our sample on the executive function/psychomotor speed domain. These findings suggest that recurrent DKA may negatively impact the brain health of older patients with T1D and highlight the importance of DKA prevention.


2020 ◽  
Vol 34 (1) ◽  
pp. 25-30
Author(s):  
Chloe W. Eng ◽  
Paola Gilsanz ◽  
Mary E. Lacy ◽  
Michal Schnaider Beeri ◽  
Rachel A. Whitmer

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