Managing type 1 diabetes: trends and outcomes over 20 years in the Wisconsin Diabetes Registry cohort.

CONTEXT

The Wisconsin Diabetes Registry Study is a Wisconsin cohort of patients with type 1 diabetes, who were diagnosed in 1987-1992 and actively followed. The study provides patients and health care professionals with better prognostic information and helps identify aspects of diabetes management that need improvement.

OBJECTIVE

To describe diabetes management and acute and chronic complications from the time of diagnosis.

DESIGN AND SETTING

All incident cases diagnosed at age <30 in 28 counties were eligible and 590 enrolled. A baseline interview, blood sample kits, biannual/annual questionnaires and study examinations at 4, 7, 9, 14, and 20 years duration were administered.

MAIN OUTCOME MEASURES

Diabetes management indicators, general health, and acute and chronic complications.

RESULTS

Glycemic control was poor in adolescence, but improved with age. A high percentage of individuals do not meet treatment standards for blood pressure and lipid profile. Self-reported health deteriorated with age, and body mass index was similar to that of the general US population. Chronic complications were present at 15-20 years, but tended to be relatively mild.

CONCLUSION

There is room for improvement in diabetes management, especially in meeting goals for blood pressure and lipid profile. Nonetheless, individuals with type 1 diabetes can be offered a more optimistic prognosis than in the past.