1. Glycemic control is not related to cerebral small vessel disease in neurologically asymptomatic individuals with type 1 diabetes
- Author
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Turgut Tatlisumak, Jukka Putaala, Lena M. Thorn, Sara Shams, Per-Henrik Groop, Carol Forsblom, Jussi Inkeri, Ron Liebkind, Daniel Gordin, Valma Harjutsalo, Krishna Adeshara, Juha Martola, HUS Medical Imaging Center, Department of Diagnostics and Therapeutics, Nefrologian yksikkö, HUS Abdominal Center, CAMM - Research Program for Clinical and Molecular Metabolism, Research Programs Unit, HUS Neurocenter, Neurologian yksikkö, Department of General Practice and Primary Health Care, Department of Medicine, Per Henrik Groop / Principal Investigator, and Clinicum
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medicine.medical_specialty ,MICROBLEEDS ,Endocrinology, Diabetes and Metabolism ,Cerebral small vessel disease ,030209 endocrinology & metabolism ,RETINOPATHY ,MICROVASCULAR COMPLICATIONS ,Asymptomatic ,Diabetic nephropathy ,03 medical and health sciences ,chemistry.chemical_compound ,Magnetic resonance imaging ,HBA(1C) VARIABILITY ,0302 clinical medicine ,Endocrinology ,Glycated albumin ,RISK-FACTOR ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,BRAIN ,ALL-CAUSE MORTALITY ,Glycemic ,Long-term glycemic fluctuations ,Type 1 diabetes ,business.industry ,General Medicine ,medicine.disease ,A1C ,Hyperintensity ,3. Good health ,Fructosamine ,chemistry ,3121 General medicine, internal medicine and other clinical medicine ,Glycated hemoglobin ,medicine.symptom ,business ,STROKE ,030217 neurology & neurosurgery ,STANDARDS - Abstract
Aims To determine if medium- and long-term blood glucose control as well as glycemic variability, which are known to be strong predictors of vascular complications, are associated with underlying cerebral small vessel disease (cSVD) in neurologically asymptomatic individuals with type 1 diabetes. Methods A total of 189 individuals (47.1% men; median age 40.0, IQR 33.0–45.2 years) with type 1 diabetes (median diabetes duration of 21.7, IQR 18.3–30.7 years) were enrolled in a cross-sectional retrospective study, as part of the Finnish Diabetic Nephropathy (FinnDiane) Study. Glycated hemoglobin (HbA1c) values were collected over the course of ten years before the visit including a clinical examination, biochemical sampling, and brain magnetic resonance imaging. Markers of glycemic control, measured during the visit, included HbA1c, fructosamine, and glycated albumin. Results Signs of cSVD were present in 66 (34.9%) individuals. Medium- and long-term glucose control and glycemic variability did not differ in individuals with signs of cSVD compared to those without. Further, no difference in any of the blood glucose variables and cSVD stratified for cerebral microbleeds (CMBs) or white matter hyperintensities were detected. Neither were numbers of CMBs associated with the studied glucose variables. Additionally, after dividing the studied variables into quartiles, no association with cSVD was observed. Conclusions We observed no association between glycemic control and cSVD in neurologically asymptomatic individuals with type 1 diabetes. This finding was unexpected considering the large number of signs of cerebrovascular pathology in these people after two decades of chronic hyperglycemia and warrants further studies searching for underlying factors of cSVD.
- Published
- 2021
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