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Observational Study
. 2024 Sep 5;12(4):e004024.
doi: 10.1136/bmjdrc-2024-004024.

Increased incidence of neurodegenerative diseases in Finnish individuals with type 1 diabetes

Susanna Satuli-Autere  1   2 , Valma Harjutsalo  1   3 , Marika I Eriksson  1   3 , Stefanie Hägg-Holmberg  1   3 , Hanna Öhman  4 , Tor-Björn Claesson  1   5 , Per-Henrik Groop  6   7 , Lena M Thorn  8   9 ; FinnDiane Study Group
Affiliations
Observational Study

Increased incidence of neurodegenerative diseases in Finnish individuals with type 1 diabetes

Susanna Satuli-Autere et al. BMJ Open Diabetes Res Care. .

Abstract

Introduction: Diabetes is linked to neurodegenerative diseases (NDs), but data in type 1 diabetes are scarce. Our aim was to assess the standardized incidence ratios (SIRs) of different NDs in type 1 diabetes, and to evaluate the impact of diabetic vascular complications and age at diabetes onset.

Research design and methods: In this observational cohort study, we included 4261 individuals with type 1 diabetes from the Finnish Diabetic Nephropathy study, and 11 653 matched population-based controls without diabetes. NDs were identified from registers until the end of 2017. Diabetic complications were assessed at the baseline study visit. SIRs were calculated from diabetes onset, except for impact of complications that was calculated from baseline study visit.

Results: The SIRs for NDs were increased in type 1 diabetes: any dementia 2.24 (95% CI 1.79 to 2.77), Alzheimer's disease 2.13 (95% CI 1.55 to 2.87), vascular dementia 3.40 (95% CI 2.08 to 5.6), other dementias 1.70 (95% CI 1.22 to 2.31), and Parkinson's disease 1.61 (95% CI 1.04 to 2.37). SIR showed a twofold increased incidence already in those without albuminuria (1.99 (1.44-2.68)), but further increased in presence of diabetic complications: kidney disease increased SIR for Alzheimer's disease, while cardiovascular disease increased SIR for both Alzheimer's disease and other dementias. Diabetes onset <15 years, compared with ≥15 years, increased SIR of Alzheimer's disease, 3.89 (2.21-6.35) vs 1.73 (1.16-2.48), p<0.05, but not the other dementias.

Conclusions: ND incidence is increased 1.7-3.4-fold in type 1 diabetes. The presence of diabetic kidney disease and cardiovascular disease further increased the incidence of dementia.

Keywords: Dementia; Diabetes Complications; Diabetes Mellitus, Type 1; Incidence.

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Conflict of interest statement

Competing interests: MIE is a shareholder of BCB Medical. P-HG reports receiving lecture fees from Astellas Pharma, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Elo Water, Genzyme, Medscape, Merck, Sharp & Dohme, Mundipharma, Novartis, Novo Nordisk, PeerVoice, Sanofi, and Sciarc. P-HG reports being an advisory board member for AbbVie, Astellas Pharma, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Janssen Pharmaceuticals, Medscape, Merck, Sharp & Dohme, Mundipharma, Nestlé, Novartis, Novo Nordisk, and Sanofi.

Figures

Figure 1
Figure 1. Selection of the Finnish Diabetic Nephropathy (FinnDiane) cohort and their matched controls without diabetes.
Figure 2
Figure 2. Standardized incidence ratios (SIRs) of neurodegenerative diseases between individuals with type 1 diabetes and controls without diabetes in 10-year age groups.
See this image and copyright information in PMC

References

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