Retrospective analysis of patients with decompensated type 1 diabetes mellitus: identifying predictors of adverse outcome

Aim . To study clinicopathological and echocardiographic da ta and long-term outcomes of patients hospitalized with decom pensated type 1 diabetes mellitus (T1DM), and to analyze pos sible associations of these factors with adverse outcomes during follow-up. Material and Methods . Here we analyzed case his tories of 502 patients with decompensated T1DM admitted to Vinogradov City Clinical Hospital (Moscow) between Febru ary 2022 and January 2024. Vital status during the long-term follow-up was determined through phone contact with patients or their close relatives. Associations between clinical data and long-term outcomes were assessed using univariate regression analysis. Follow-up outcomes were determined at 18.5 [12.4; 24.0] months after discharge. Patients were divided into two groups: survivors (n = 476) and patients with fatal outcomes (n = 26). Results . Survivors were characterized by younger age, low er glycated hemoglobin levels, and shorter T1DM duration (p < 0.05). Older age (Hazard Ratio (HR) 1.085; 95 % Confidence Interval (CI) [1.058–1.113]), arterial hypertension (HR 3.180; 95 % CI [1.457–6.939]), higher glycated hemoglobin level (HR 14.0; 95 % CI [6.6–29.5]), and longer duration of T1DM (HR 1.063; 95 % CI [1.020–1.107]) were significantly associated with mortality in the long-term period (p < 0.05). Percutaneous coronary intervention (HR 5.183; 95 % CI [1.223–21.956]) and chronic heart failure (HR 9.172; 95 % CI [3.830–21.963]) had a negative prognostic impact on long-term outcomes (p < 0.05). Conclusion . Older age, longer disease duration, higher glycated hemoglobin levels, and arterial hypertension are significant pre dictors of long-term mortality in patients with T1DM. A history of percutaneous coronary intervention and chronic heart failure further worsen the long-term prognosis in this patient popula tion.