Lasse Bjerg Hansen - Clustering of microvascular and macrovascular complications in diabetic populations

It is known that the three microvascular complications of diabetes, affecting the retina, kidney and peripheral nervous system, are determined to a large degree by how well glucose levels are managed and by the duration of diabetes. However, even at a similar level of glycaemic control and diabetes duration, some patients develop complications earlier and experience a more aggressive progression of these complications than others.

Studies so far have often focused on each complication separately. We hypothesise that considering diabetic complications as a cluster will provide a more powerful way of distinguishing pathophysiological determinants of any of the complications (such as glucose) from factors with specific or different effects on each type of complication.

The project will examine whether the clinical care model for patients with diabetes can be improved by basing it on an understanding of its main small-vessel (microvascular) complications as a cluster rather than simply as a set of separate diagnoses.

The project is based on epidemiological analyses in different Danish diabetes populations: Type 1 DM in a clinical patient cohort at Steno Diabetes Center and type 2 diabetes based on the 10 year follow-up re-examination (2015-2016) of the Danish arm of the ADDITION trial, with a strong focus on clinical and subclinical measures of micro- and macrovascular complications.

Complementary to the Danish study, during an exchange at the university of Edinburgh, we will examine clustreing of complications by using population-based diabetes register linked to hospital admission, cancer registration and mortality databases in Scotland.