Why the study?
Complications in type 1 diabetes can be reduced by modifying risk factors, motivating the development of a clinical risk score for microvascular complications.
Can a clinical risk score using five routine clinical variables accurately predict the risk of microvascular complications in patients with type 1 diabetes?
Can a clinical risk score using five routine clinical variables accurately predict the risk of microvascular complications in patients with type 1 diabetes?
A newly developed clinical risk calculator using five routine variables demonstrates strong discriminative ability for predicting microvascular complications in patients with type 1 diabetes.
May aid T1D microvascular risk stratification; leaves open prospective validation before clinical adoption.
Development of complications in type 1 diabetes patients can be reduced by modifying risk factors. We used a cross-sectional cohort of 1646 patients diagnosed with type 1 diabetes (T1D) to develop a clinical risk score for diabetic peripheral neuropathy (DPN), autonomic neuropathy (AN), retinopathy (DR), and nephropathy (DN). Of these patients, 199 (12.1%) had DPN, 63 (3.8%) had AN, 244 (14.9%) had DR, and 88 (5.4%) had DN. We selected five variables to include in each of the four microvascular complications risk models: age, age of T1D diagnosis, duration of T1D, and average systolic blood pressure and HbA1C over the last three clinic visits. These variables were selected for their strong evidence of association with diabetic complications in the literature and because they are modifiable risk factors. We found the optimism-corrected R2 and Harrell's C statistic were 0.39 and 0.87 for DPN, 0.24 and 0.86 for AN, 0.49 and 0.91 for DR, and 0.22 and 0.83 for DN, respectively. This tool was built to help inform patients of their current risk of microvascular complications and to motivate patients to control their HbA1c and systolic blood pressure in order to reduce their risk of these complications.
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Tran et al. (2021) studied this question.
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