BP, cholesterol control key for Type1 diabetics, says study

Clinical parameters play key role with blood sugar control in long term survival, says first pan-India study

Updated - October 02, 2021 01:09 pm IST - CHENNAI

India is home to more than 95,000 children with Type 1 diabetes

India is home to more than 95,000 children with Type 1 diabetes

Good control of not only blood sugar, but also blood pressure and cholesterol is essential for survival and a good quality of life among Type 1 diabetics (T1D), according to a pan India study of long-term survivors with the condition.

A first-of-its kind report of long term survivors of T1D from India, a multi-centric study was published in the peer-reviewed journal Diabetes Technology and Therapeutics . Comparing survivors for over 40 years with people who did not survive up to 40 years, the researchers found that “survivors had better glycemic and blood pressure control, more favourable lipid profiles and lower prevalence of complications compared to non-survivors.”

However, they added that “there could be other protective factors as well, which merit further studies”. The survivors also had better height and weight parameters compared to the other group.

Individuals with T1D have increased morbidity and excess premature mortality compared to those without diabetes and their life expectancy is reduced by an estimated 15-20 years, even with the life-saving insulin to their assistance. However, long-term survival with T1D is possible and 40% of European individuals with T1D are reported to survive for more than 40 years with life expectancy now extending almost up to 70 years, the paper added. In fact, two patients in the study have lived over 70 years with T1D, said V. Mohan, of Dr. Mohan’s Diabetes Specialties Centre (DMDSC), and lead author.

A total of 127 participants with T1D were included in the study which comprised of 76 survivors of over 40 years duration and 51 non-survivors. Of the 76 survivors, 59 were from DMDSC, the coordinating centre in Chennai, and 17 from other participating centres (5 from the Madras Medical College, Chennai; 5 from Ahmedabad, 3 from Delhi, 2 from Kolkata and 1 each from Mumbai and Nagpur). Among the 76 T1D survivors, 58 individuals had survived 40-49 years with diabetes, 12 individuals 50-59 years and 6 individuals, over 60 years with diabetes.

India is home to more than 95,000 children with T1D, reported to be the highest in the world, according to the 9th International Diabetes Federation Atlas, the study points out, but most reports on long term survival were from the U.S. and Europe and none from India. Given that life expectancy in India is in general lower, the subject definitely needs attention, the authors argued.

While the study showed a significant differentiation in blood glucose, blood pressure and cholesterol levels determining better survival and quality of life, Dr. Mohan said it was interesting that many of the long term survivors in the study were not prescribed intensive insulin therapy in the first 10 years or so after diagnosis, and they still seemed to be protected from complications. This definitely calls for more studies, he added.

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