T1DMicro: A Clinical Risk Calculator for Type 1 Diabetes Related Microvascular Complications

Paul Minh Huy Tran, Eileen Kim, Lynn Kim Hoang Tran, Bin Satter Khaled, Diane Hopkins, Melissa Gardiner, Jennifer Bryant, Risa Bernard, John Morgan, Bruce Bode, John Chip Reed, Jin-Xiong She and Sharad Purohit
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Paul Minh Huy Tran: Center for Biotechnology and Genomic Medicine, Augusta University, 1120, 15th Str., Augusta, GA 30912, USA
Eileen Kim: Center for Biotechnology and Genomic Medicine, Augusta University, 1120, 15th Str., Augusta, GA 30912, USA
Lynn Kim Hoang Tran: Center for Biotechnology and Genomic Medicine, Augusta University, 1120, 15th Str., Augusta, GA 30912, USA
Bin Satter Khaled: Center for Biotechnology and Genomic Medicine, Augusta University, 1120, 15th Str., Augusta, GA 30912, USA
Diane Hopkins: Center for Biotechnology and Genomic Medicine, Augusta University, 1120, 15th Str., Augusta, GA 30912, USA
Melissa Gardiner: Center for Biotechnology and Genomic Medicine, Augusta University, 1120, 15th Str., Augusta, GA 30912, USA
Jennifer Bryant: Center for Biotechnology and Genomic Medicine, Augusta University, 1120, 15th Str., Augusta, GA 30912, USA
Risa Bernard: Center for Biotechnology and Genomic Medicine, Augusta University, 1120, 15th Str., Augusta, GA 30912, USA
John Morgan: Department of Neurology, Medical College of Georgia, Augusta University, 1120, 15th Str., Augusta, GA 30912, USA
Bruce Bode: Atlanta Diabetes Associates, Atlanta, GA 30318, USA
John Chip Reed: Southeastern Endocrine and Diabetes, Atlanta, GA 30076, USA
Jin-Xiong She: Center for Biotechnology and Genomic Medicine, Augusta University, 1120, 15th Str., Augusta, GA 30912, USA
Sharad Purohit: Center for Biotechnology and Genomic Medicine, Augusta University, 1120, 15th Str., Augusta, GA 30912, USA

IJERPH, 2021, vol. 18, issue 21, 1-12

Abstract: 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.

Keywords: type 1 diabetes; complications; peripheral and autonomic neuropathy; retinopathy; nephropathy; risk prediction; clinical calculator (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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