ArticleDiabetes care2013
Changing impact of modifiable risk factors on the incidence of major outcomes of type 1 diabetes: the Pittsburgh Epidemiology of Diabetes Complications Study.
Article in Diabetes care, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 43 citations in OpenAlex.
- Risk of Foot Ulcer and Lower-Extremity Amputation Among Participants in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study.Diabetes care · 2022Trial
- Insulin Resistance in Type 1 Diabetes: Concepts and Implications for Therapy.Journal of diabetes · 2025Article
- Hyperlipidemia and Cardiovascular Disease in People with Type 1 Diabetes: Review of Current Guidelines and Evidence.Current cardiology reports · 2023Review
- Cardiovascular Disease in Adults with Type 1 Diabetes: Looking Beyond Glycemic Control.Current cardiology reports · 2022Review
- Optimal Blood Pressure Thresholds for Minimal Coronary Artery Disease Risk in Type 1 Diabetes.Diabetes care · 2019Article
- Cardiovascular Risk in Type 1 Diabetes Mellitus.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2019Review
- Factors Affecting Cardiovascular Risk in Children, Adolescents, and Young Adults with Type 1 Diabetes.Journal of diabetes research · 2019Article
- Dose-dependent effect of smoking on risk of coronary heart disease, heart failure and stroke in individuals with type 1 diabetes.Diabetologia · 2018Article
- Trends in cardiovascular risk factor management in type 1 diabetes by sex.Journal of diabetes and its complications · 2018Article
- Left ventricular systolic dysfunction predicts long-term major microvascular complication outcomes in type 1 diabetes. The Pittsburgh Epidemiology of Diabetes Complications (EDC) study of childhood onset diabetes.Journal of diabetes and its complications · 2018Article
- Approach for a Clinically Useful Comprehensive Classification of Vascular and Neural Aspects of Diabetic Retinal Disease.Investigative ophthalmology & visual science · 2018Article
- Diabetes Care Disparities in Long-standing Type 1 Diabetes in Canada and the U.S.: A Cross-sectional Comparison.Diabetes care · 2018Article
- Treatment of Dyslipidemia in Diabetes: Recent Advances and Remaining Questions.Current diabetes reports · 2017Review
- The course of diabetes in children, adolescents and young adults: does the autoimmunity status matter?BMC endocrine disorders · 2016Article
- High hemoglobin A1c variability is associated with early risk of microalbuminuria in children with T1D.Pediatric diabetes · 2016Article
- Risk Factors for Cardiovascular Disease in Type 1 Diabetes.Diabetes · 2016Observational
- Lower-extremity amputation as a marker for renal and cardiovascular events and mortality in patients with long standing type 1 diabetes.Cardiovascular diabetology · 2016Observational
- Defining pathways for development of disease-modifying therapies in children with type 1 diabetes: a consensus report.Diabetes care · 2015Review
- Hypertension and Diabetic Kidney Disease in Children and Adolescents.Diabetes spectrum : a publication of the American Diabetes Association · 2015Article
- Urinary MicroRNA Profiling Predicts the Development of Microalbuminuria in Patients with Type 1 Diabetes.Journal of clinical medicine · 2015Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
objectiveThe incidence of type 1 diabetes complications appears to be decreasing, but relative contributions of risk factors are unclear. We thus estimated the effect of modifiable risk factors on the incidence of a composite end point, major outcomes of diabetes (MOD). RESEARCH DESIGN AND
methodsThe Pittsburgh Epidemiology of Diabetes Complications (EDC) Study was used to derive two cohorts based on diabetes diagnosis year (1960-1969 and 1970-1980). Baseline exam data in the current analysis for the 1960s group were collected in 1986-1988 and for the 1970s in 1996-1998. Each group was followed for 8 years for MOD incidence (diabetes-related death, myocardial infarction, revascularization procedure/blockage ≥50%, stroke, end-stage renal disease, blindness, and amputation). Assessed risk factors include the following: HbA1c, hypertension, microalbuminuria, BMI, hypercholesterolemia, and smoking. Accelerated failure time models were used to estimate the acceleration factor.
resultsMOD incidence decreased in the 1970s cohort (15.8% [95% CI 11.6-21.4]) compared with the 1960s (22.6% [17.0-29.1]) over the 8-year follow-up (P = 0.06). Hypertension and microalbuminuria were associated with significantly accelerated MOD incidence in both cohorts (P < 0.01 for both). High HbA1c (P = 0.0005), hypercholesterolemia (P = 0.01), and current smoking (P = 0.003) significantly accelerated the incidence of MOD in the 1960s but not 1970s cohort. BMI was not associated with MOD in either cohort.
conclusionsThese results suggest that hypertension and microalbuminuria remain important predictors of complications that are not being adequately addressed.
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