Diabetes, obesity & metabolism · 2026
Health Inequities in Older Adults With Type 1 Diabetes: A Nationwide Registry Analysis of Sociodemographic and Clinical Profiles for Glycaemic Control and Complications.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Deng Chao, Fan Wenqi, Xie Yuting, Tang Xiaohan, Jiang Hongwei, Niu Xiaohong, Yan Dewen, Su Heng, Kuang Hongyu, Tian Limin, Liu Jing, Jiang Sheng, Quan Huibiao, Xu Jixiong, Wu Xiaohong, Tao Na, Sun Shuguang, Li Juan, Guo Rui, Chen Yan, He Binbin, Fan Li, Cao Chuqin, Huang Fansu, Huang Gan, Zhou Zhiguang, Li Xia, CD1S Study Group
Аннотация
AIMS: Despite its rising prevalence, older adults with Type 1 diabetes remain poorly characterised. This study aimed to characterise those over 60 years and quantify independent predictors of glycaemic control and complications.
MATERIALS AND METHODS: We performed a multicentre analysis using real-world data from the China Diabetes Type 1 Study (CD1S), including 69 centres across China between 2016 and 2021. Patients were stratified into three age groups (≥ 60, 18-59 and < 18 years) for assessment of clinical characteristics and complications. Multiple regression examined associations of clinical features with HbA1c and complications. Variable importance was interpreted using SHAP values derived from a random forest model.
RESULTS: We enrolled 9637 patients with Type 1 diabetes. Compared with young adults, older adults with Type 1 diabetes were less likely to achieve target HbA1c (7.2% vs. 10.2%, p < 0.05) and had a substantially higher burden of chronic complications, with 81.0% of older adults having at least one complication. Longer duration, higher BMI and higher gross domestic product (GDP) were significantly associated with lower HbA1c (all p < 0.05). Higher GDP was linked to reduced rates of diabetic retinopathy (19.7%), nephropathy (13.6%) and peripheral neuropathy (46.9%), yet a higher proportion of peripheral vasculopathy (41.8%) was observed compared with middle- and low-GDP regions.
CONCLUSIONS: Older adults with Type 1 diabetes exhibit a unique clinical profile of poor glycaemic control and a high burden of complications, influenced by regional GDP disparities. This underscores the critical need to integrate socioeconomic factors into personalised care strategies to advance health equity.
REGISTRATION NUMBER: NCT05498974.
MATERIALS AND METHODS: We performed a multicentre analysis using real-world data from the China Diabetes Type 1 Study (CD1S), including 69 centres across China between 2016 and 2021. Patients were stratified into three age groups (≥ 60, 18-59 and < 18 years) for assessment of clinical characteristics and complications. Multiple regression examined associations of clinical features with HbA1c and complications. Variable importance was interpreted using SHAP values derived from a random forest model.
RESULTS: We enrolled 9637 patients with Type 1 diabetes. Compared with young adults, older adults with Type 1 diabetes were less likely to achieve target HbA1c (7.2% vs. 10.2%, p < 0.05) and had a substantially higher burden of chronic complications, with 81.0% of older adults having at least one complication. Longer duration, higher BMI and higher gross domestic product (GDP) were significantly associated with lower HbA1c (all p < 0.05). Higher GDP was linked to reduced rates of diabetic retinopathy (19.7%), nephropathy (13.6%) and peripheral neuropathy (46.9%), yet a higher proportion of peripheral vasculopathy (41.8%) was observed compared with middle- and low-GDP regions.
CONCLUSIONS: Older adults with Type 1 diabetes exhibit a unique clinical profile of poor glycaemic control and a high burden of complications, influenced by regional GDP disparities. This underscores the critical need to integrate socioeconomic factors into personalised care strategies to advance health equity.
REGISTRATION NUMBER: NCT05498974.