AI study of risk factors in type 1 diabetes

March 06, 2019

In combination with conventional statistical methods, artificial intelligence (AI) has now been used in a study of risk factors in type 1 diabetes. The objective was to identify the most important indicators of elevated risk for cardiovascular disease and death.

"What's unique about this study is that we've included machine learning analyses -- that is, algorithms for AI -- to assess strength of association for cardiovascular risk factors", says Aidin Rawshani, PhD, of Sahlgrenska Academy, University of Gothenburg. Dr Rawshani is the corresponding author of a new article in the journal Circulation.

The study is based on register data concerning 32,611 people with type 1 diabetes for whom the mean duration of the disease had been 18 years. Follow-up time averaged just over 10 years. Alongside traditional statistical analysis, AI was used: Autonomous learning enabled the computer software to improve its ability to predict death and cardiovascular events.

When the relative contribution of 17 risk factors was studied, five emerged as the strongest predictors: high long-term blood sugar (glycated hemoglobin) levels, kidney dysfunction, duration of type 1 diabetes, high systolic blood pressure (the first, higher figure of the two measured) and an excess of what is popularly known as "bad cholesterol" (low-density lipoprotein, LDL).

Long-term high blood sugar a crucial factor

For three variables -- blood sugar, systolic blood pressure and LDL -- levels below those currently recommended in national guidelines proved to be associated with lower risks of cardiovascular disease and death.

Another finding in the study was the association between albuminuria (elevated levels of protein in the urine) and two- to fourfold risk elevation for the outcomes studied. Along with long-term high blood sugar, albuminuria was the factor that most clearly predicted these outcomes.

According to machine learning models, high blood sugar is believed to contribute to the development of the other cardiovascular risk factors. In addition, the researchers found a clear interaction effect between risk factors that cannot be influenced (age and duration of diabetes) and those that can (long-term high blood sugar, systolic blood pressure, LDL cholesterol and albuminuria).

Focus on factors subject to influence

The research group behind the study has previously shown that individuals with type 1 diabetes who succeed in keeping more than one risk factor under control are at lower risk of myocardial infarction and stroke, but that their risk of death and heart failure is still elevated.

The present study shows that the key predictors of cardiovascular disease and death in the patient group are mainly conventional risk factors that, except for age and duration of diabetes, can be influenced.

"An increased clinical focus on these risk factors should result in the largest relative risk reduction for death and cardiovascular disease," says Aidin Rawshani.
-end-
Title: Relative Prognostic Importance and Optimal Levels of Risk Factors for Mortality and Cardiovascular Outcomes in Type 1 Diabetes; http://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.037454

University of Gothenburg

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.