The Association of Skin-Intrinsic Fluorescence With Type 1 Diabetes Complications in the DCCT/EDIC Study

      Research output: Contribution to journalArticle

      Published
      • Trevor J Orchard
      • Timothy J Lyons
      • Patricia A Cleary
      • Barbara H Braffett
      • John Maynard
      • Catherine Cowie
      • Rose A Gubitosi-Klug
      • Jeff Way
      • Karen Anderson
      • Annette Barnie
      • Stephan Villavicencio
      • the DCCT/EDIC Research Group

      View graph of relations

      OBJECTIVE

      To determine whether skin intrinsic fluorescence (SIF) is associated with long-term complications of type 1 diabetes (T1D) and, if so, whether it is independent of chronic glycemic exposure and previous intensive therapy.

       

      RESEARCH DESIGN AND METHODS

       We studied 1,185 (92%) of 1,289 active Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) participants from 2010 to 2011. SIF was determined using a fluorescence spectrometer and related cross-sectionally to recently determined measures of retinopathy (stereo fundus photography), cardiac autonomic neuropathy (CAN; R-R interval), confirmed clinical neuropathy, nephropathy (albumin excretion rate [AER]), and coronary artery calcification (CAC).

       

      RESULTS

      Overall, moderately strong associations were seen with all complications, before adjustment for mean HbA1c over time, which rendered these associations nonsignificant with the exception of sustained AER >30 mg/24 h and CAC, which were largely unaffected by adjustment. However, when examined within the former DCCT treatment group, associations were generally weaker in the intensive group and nonsignificant after adjustment, while in the conventional group, associations remained significant for CAN, sustained AER >30 mg/24 h, and CAC even after mean HbA1c adjustment.

       

      CONCLUSIONS

       SIF is associated with T1D complications in DCCT\EDIC. Much of this association appears to be related to historical glycemic exposure, particularly in the previously intensively treated participants, in whom adjustment for HbA1c eliminates statistical significance.

      DOI

      Original languageEnglish
      Pages (from-to)3146-3153
      JournalDiabetes Care
      Journal publication date28 Jun 2013
      Issue number10
      Volume36
      DOIs
      StatePublished - 28 Jun 2013

      ID: 5034323