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Open Access 01-12-2022 | Diabetic Retinopathy | Research article

Frailty and risk of microvascular complications in patients with type 2 diabetes: a population-based cohort study

Authors: Yuanjue Wu, Ting Xiong, Xiao Tan, Liangkai Chen

Published in: BMC Medicine | Issue 1/2022

Abstract

Background

Cross-sectional studies found that frailty was associated with prevalent diabetic microvascular complications (DMC). Longitudinal evidence in this regard is inconclusive and insufficient. We aimed to prospectively evaluate the association of pre-frailty and frailty with DMC in patients with type 2 diabetes (T2D).

Methods

We included 18,062 adults (mean age 59.4 ± 7.2 years, 37.4% female) with T2D at baseline in the UK Biobank. Frailty was defined using the frailty phenotype according to five components (weight loss, exhaustion, low physical activity, slow gait speed, and low grip strength). DMC, defined as diabetic nephropathy, diabetic neuropathy, or diabetic retinopathy, was identified using hospital inpatient records and death registries. Cox proportional hazard regression models considering competing risks were used to evaluate the associations of frailty phenotype with overall DMC events and subtypes.

Results

Among all participants, 6101 (33.8%) were classified as non-frail, 10,073 (55.8%) were classified as pre-frail, and 1888 (10.4%) were classified as frail. During a median follow-up of 12.0 years, 3678 DMC cases were documented, including 2213 diabetic nephropathy, 1520 diabetic retinopathy, and 673 diabetic neuropathy events. In the multivariable-adjusted model, compared with participants with non-frail, both pre-frailty and frailty were significantly associated with increased risk of overall DMC (HR 1.10, 95% CI: [1.02, 1.18] for pre-frailty and HR 1.52 [95% CI: 1.36, 1.69] for frailty). Similar results were observed in the subtypes of DMC. For each one-point increase in frailty phenotype score, the risk of overall DMC, diabetic nephropathy, diabetic retinopathy, and diabetic neuropathy event increased by 13%, 16%, 10%, and 20%, respectively.

Conclusions

Both pre-frailty and frailty were associated with an increased risk of DMC in patients with T2D. These findings have important implications for integrating early assessment and surveillance of frailty in diabetes and may favor the identification of at-risk patients.

Available only for authorised users

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Title: Frailty and risk of microvascular complications in patients with type 2 diabetes: a population-based cohort study
Authors: Yuanjue Wu
Ting Xiong
Xiao Tan
Liangkai Chen
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Diabetic Retinopathy
Diabetic Neuropathy
Diabetic Retinopathy
Diabetic Neuropathy
Diabetic Nephropathy
Type 2 Diabetes
Published in: BMC Medicine / Issue 1/2022
Electronic ISSN: 1741-7015
DOI: https://doi.org/10.1186/s12916-022-02675-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Frailty and risk of microvascular complications in patients with type 2 diabetes: a population-based cohort study

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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