SFDT1 Cohort: Follow-up Study in France of People Living with Type 1 Diabetes

primary evaluation

Occurrence of major adverse cardiovascular events (MACE), including: nonfatal myocardial infarction Non-fatal stroke death from cardiovascular causes (death occurring within 30 days of a diagnosis of myocardial infarction, stroke, unstable angina, heart failure, sudden cardiac arrest, cardiogenic shock, other cerebrovascular events, or other cardiovascular events recorded in a reimbursement claim, regardless of the context of care) MACE data are collected from investigators every 3 years, or through the SNDS via associated reimbursed events (ICD-9-CM and ICD-10-CM codes).

secondary evaluation

Events to Explain Macrovascular complications: Each component of MACE is examined separately Microvascular complications: retinopathy and maculopathy (Wilkinson's international classification) kidney disease (serum creatinine, albumin-to-creatinine ratio, dialysis, kidney transplant) neuropathy (routine clinical examination, Michigan score) and simple questions about autonomic neuropathy foot deformity and history of amputation Other complications: musculoskeletal disorders, periodontal diseases, cancers (a few routine questions) Mortality Quality of Life (EQ-5D-5L) Factors Examined (by Secondary Objective) Traditional risk factors for MACE: age, sex, smoking, high blood pressure, dyslipidemia and lipid-lowering medications, antiplatelet therapy, family history of early MACE, bariatric surgery, sleep apnea syndrome, history of arterial disease, women’s health (menstruation, contraception, menopause, polycystic ovary syndrome, pregnancies, breastfeeding), and frailty in patients aged 65 and older. Glycemic variability and hypoglycemia: coefficient of variation and standard deviation of blood glucose levels (MCG data); Level 1 hypoglycemia (< 70 and ≥ 54 mg/dL), Level 2 (< 54 mg/dL), and Level 3 (severe, requiring assistance); number of severe events over the past 12 months; perception of hypoglycemia (Gold and Clarke scores). Relationship between microangiopathy and macroangiopathy: criteria described above (microvascular complications). Biomarkers and metabolic pathways: biobank (inflammatory markers such as CRP, IL-6, fibrinogen, adiponectin, and CD34+ cells; hair analyses for environmental exposure) and genetic and epigenetic markers. Psychosocial factors: educational attainment and employment status; validated questionnaires (eating disorders, precarious living conditions, anxiety, etc.). Therapeutic innovations and care: number of visits, functional insulin therapy, insulin regimens and doses, other antidiabetic medications (metformin, GLP-1 agonists), insulin pump, CGM, predictive suspension systems, telemedicine, closed-loop systems, islet transplantation; metabolic control (HbA1c, weight, waist circumference, liver enzymes, history of ketoacidosis, CGM indicators: time spent in different glycemic zones and estimated HbA1c / GMI). Impact of Medications: Antidiabetic and Non-Antidiabetic Treatments, as recorded in the observation log. Economic burden (SNDS data): patient characteristics (age, sex, department, health insurance coverage, deprivation index, date of death) and healthcare utilization and associated costs (fees, prescription drugs, laboratory tests, imaging, nursing care, physical therapy, medical devices, transportation, hospitalizations, daily allowances, disability pensions).