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Peer-reviewedCC BY-NC-ND 4.0Diabetes, Obesity & Metabolism

Prevalence of Chronic Complications After Inaugural Admission in Intensive Care Unit for Type 1 Diabetes in the SFDT1 Cohort: The INAUGURAL Study

  • Emmanuel Cosson1,2,3
  • Gloria Aguayo4
  • Amandine Créquer‐Grandhomme5
  • Amar Bahloul5
  • Eric Renard6
  • Louis Potier7,8
  • Pauline Schaepelynck9
  • Agnès Sola‐Gazagnes10
  • Anne Spiteri11
  • Jean‐Pierre Riveline12,13
  • Guy Fagherazzi4
13 affiliations
  1. 1Department of Endocrinology, Diabetology and Nutrition, Avicenne Hospital Assistance Publique–Hôpitaux de Paris (AP‐HP) Bobigny France
  2. 2Clinical Research Center in Human Nutrition (CRNH‐IdF), Île‐de‐France Nord Specialized Center for Obesity (CSO) University Sorbonne Paris Nord Bobigny France
  3. 3Nutritional Epidemiology Research Team (EREN), Center for Research in Epidemiology and Statistics (CRESS) University Sorbonne Paris Nord and Paris Cité University, INSERM, INRAE, CNAM Bobigny France
  4. 4Department of Precision Health, Deep Digital Phenotyping Unit Luxembourg Institute of Health Strassen Luxembourg
  5. 5Sanofi Gentilly France
  6. 6Department of Endocrinology and Diabetology Montpellier University Hospital, University of Montpellier, INSERM, CNRS Montpellier France
  7. 7Department of Diabetology and Endocrinology, Bichat Hospital Assistance Publique – Hôpitaux de Paris (AP‐HP) Paris France
  8. 8INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades, Université Paris Cité Paris France
  9. 9Department of Endocrinology and Diabetology European Hospital Marseille France
  10. 10Department of Diabetology, Cochin Hospital Assistance Publique – Hôpitaux de Paris (AP‐HP) Paris France
  11. 11Department of Pediatric Endocrinology and Diabetology, Ambulatory Care Platform Grenoble Alpes University Hospital Grenoble France
  12. 12Service de Diabètes et Endocrinologie, Hôpital Lariboisière AP‐HP Paris France
  13. 13Équipe Immunité et Métabolisme du Diabète Université Paris Cité, INSERM UMR‐S1151, CNRS UMR‐S8253, Institut Necker Enfants Malades Paris France
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Abstract

Aims: Inaugural presentation at type 1 diabetes onset, as ketoacidosis, has been associated with poorer glycaemic control, but its relationship to diabetes‐related complications remains unclear. We assessed the association between inaugural intensive care unit (ICU) admission and long‐term diabetes‐related outcomes in adults.

Materials and Methods: This cross‐sectional analysis used data from the Société Francophone du Diabète—Cohorte Diabète de Type 1 (SFDT1) cohort. We compared participants with and without an inaugural ICU admission regarding chronic complications, recent acute events, and cardiometabolic risk factors. Models were adjusted for age, sex, diabetes duration, smoking status, socioeconomic vulnerability, education, insulin therapy, HbA1c, and centre; interaction terms were tested.

Results: Among 3548 adults with type 1 diabetes (median duration 20 years [IQR 10–30]), 377 (10.6%) reported inaugural ICU admission. Retinopathy was more prevalent in the ICU group (36.6 vs. 31.4%; p < 0.05), including proliferative forms (11.1 vs. 7.7%; p < 0.05). These differences remained significant after adjustment (p < 0.05). An association with retinopathy was observed among individuals diagnosed before the age of 17 (OR = 1.5; 95% CI, 1.1–2.1; p = 0.015). Severe hypoglycaemia in the previous year was more frequent in the ICU group (15.4% vs. 10.5%; p < 0.01) and remained significant after adjustment (p < 0.05). No significant differences were observed for the other variables.

Conclusions: In this multicentre cohort of adults with long‐standing type 1 diabetes, inaugural ICU was associated with at least a 50% higher odds of severe hypoglycaemia and retinopathy, including proliferative forms. The association with retinopathy was mainly observed among individuals diagnosed at a young age.

Trial Registration: ClinicalTrials.gov (NCT04657783)

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Cite

BibTeXRIS
BibTeX
@article{cosson2026prevalence,
  title = {{Prevalence of Chronic Complications After Inaugural Admission in Intensive Care Unit for Type 1 Diabetes in the SFDT1 Cohort: The INAUGURAL Study}},
  author = {Emmanuel Cosson and Gloria Aguayo and Amandine Créquer‐Grandhomme and Amar Bahloul and Eric Renard and Louis Potier and Pauline Schaepelynck and Agnès Sola‐Gazagnes and Anne Spiteri and Jean‐Pierre Riveline and Guy Fagherazzi},
  journal = {Diabetes, Obesity \& Metabolism},
  year = {2026},
  month = oct,
  doi = {10.1111/dom.71393},
  url = {https://doi.org/10.1111/dom.71393},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Prevalence of Chronic Complications After Inaugural Admission in Intensive Care Unit for Type 1 Diabetes in the SFDT1 Cohort: The INAUGURAL Study
AU  - Emmanuel Cosson
AU  - Gloria Aguayo
AU  - Amandine Créquer‐Grandhomme
AU  - Amar Bahloul
AU  - Eric Renard
AU  - Louis Potier
AU  - Pauline Schaepelynck
AU  - Agnès Sola‐Gazagnes
AU  - Anne Spiteri
AU  - Jean‐Pierre Riveline
AU  - Guy Fagherazzi
PY  - 2026
DA  - 2026/10/02
JO  - Diabetes, Obesity & Metabolism
DO  - 10.1111/dom.71393
UR  - https://doi.org/10.1111/dom.71393
AB  - Aims: Inaugural presentation at type 1 diabetes onset, as ketoacidosis, has been associated with poorer glycaemic control, but its relationship to diabetes‐related complications remains unclear. We assessed the association between inaugural intensive care unit (ICU) admission and long‐term diabetes‐related outcomes in adults.  Materials and Methods: This cross‐sectional analysis used data from the Société Francophone du Diabète—Cohorte Diabète de Type 1 (SFDT1) cohort. We compared participants with and without an inaugural ICU admission regarding chronic complications, recent acute events, and cardiometabolic risk factors. Models were adjusted for age, sex, diabetes duration, smoking status, socioeconomic vulnerability, education, insulin therapy, HbA1c, and centre; interaction terms were tested.  Results: Among 3548 adults with type 1 diabetes (median duration 20 years [IQR 10–30]), 377 (10.6%) reported inaugural ICU admission. Retinopathy was more prevalent in the ICU group (36.6 vs. 31.4%; p < 0.05), including proliferative forms (11.1 vs. 7.7%; p < 0.05). These differences remained significant after adjustment (p < 0.05). An association with retinopathy was observed among individuals diagnosed before the age of 17 (OR = 1.5; 95% CI, 1.1–2.1; p = 0.015). Severe hypoglycaemia in the previous year was more frequent in the ICU group (15.4% vs. 10.5%; p < 0.01) and remained significant after adjustment (p < 0.05). No significant differences were observed for the other variables.  Conclusions: In this multicentre cohort of adults with long‐standing type 1 diabetes, inaugural ICU was associated with at least a 50% higher odds of severe hypoglycaemia and retinopathy, including proliferative forms. The association with retinopathy was mainly observed among individuals diagnosed at a young age.  Trial Registration: ClinicalTrials.gov (NCT04657783)
SN  - 1462-8902
SN  - 1463-1326
ER  -