A prognostic model has been developed and validated which has adequate discrimination for major outcomes in type 1 diabetes, according to a study published online ahead of print in Diabetologia.
Sabita S. Soedamah-Muthu, PhD, from Wageningen University in the Netherlands, and colleagues developed a prognostic model and quantified its performance in independent cohorts. The authors analyzed data from 1,973 participants with type 1 diabetes from the EURODIAB Prospective Complications Study who were followed for seven years.
Factors that were found to be prognostic for major outcomes were combined in a model, whose performance was tested in three prospective cohorts: the Pittsburgh Epidemiology of Diabetes Complications study (EDC; 554 participants); the Finnish Diabetic Nephropathy study (FinnDiane; 2,999 participants); and the Coronary Artery Calcification in Type 1 Diabetes study (CACTI, 580 participants).
Major coronary heart disease, stroke, end-stage renal failure, amputations, blindness, and all-cause death were included as major outcomes.
During follow-up, major outcomes developed in 95 patients from EURODIAB. Hemoglobin A1c, waist-to-hip ratio, albumin/creatinine ratio, and high-density lipoprotein cholesterol level were identified as prognostic factors. The model had adequate discriminative ability, with a concordance statistic (C-statistic) of 0.74. Similar discrimination was seen in the validation cohorts, with C-statistics of 0.79, 0.82, and 0.73 for EDC, FinnDiane, and CACTI, respectively.
“Such a prognostic model may be helpful in clinical practice and for risk stratification in clinical trials,” the investigators concluded.