---
title: "Inaugural ICU Admission at Type 1 Diabetes Onset Linked to Higher Retinopathy and Severe Hypoglyca"
id: "pubmed-42823888"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42823888"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42823888/"
doi: "10.1111/dom.71393"
published_at: "2026-10-02T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Inaugural ICU Admission at Type 1 Diabetes Onset Linked to Higher Retinopathy and Severe Hypoglyca
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42823888
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42823888/)
- **DOI:** [10.1111/dom.71393](https://doi.org/10.1111%2Fdom.71393)
- **Published At:** 2026-10-02T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This cross-sectional analysis of the SFDT1 cohort evaluated whether an **inaugural ICU** admission at type 1 diabetes onset is associated with long-term diabetes-related complications in adults. - Among 3548 adults with median diabetes duration 20 years (IQR 10–30), 377 (10.6%) reported an inaugural ICU admission. - **Retinopathy** prevalence was higher in those with inaugural ICU admission (36.6% vs 31.4%), including a greater proportion with proliferative retinopathy (11.1% vs 7.7%); these differences remained statistically significant after adjustment for covariates. - The retinopathy association was particularly observed in individuals diagnosed before age 17 (adjusted OR 1.5; 95% CI 1.1–2.1; p = 0.015). - Reports of **severe hypoglycaemia** in the previous year were more frequent in the inaugural ICU group (15.4% vs 10.5%) and this difference persisted after multivariable adjustment. - No significant differences were found between groups for the other chronic complications, recent acute events, or cardiometabolic risk factors evaluated in the analysis. - Models adjusted for age, sex, diabetes duration, smoking status, socioeconomic vulnerability, education, insulin therapy, HbA1c, and centre; interaction terms were tested. - The source abstract is truncated: the final sentence reporting fuller interpretation of the retinopathy association is incomplete, and additional methodological or subgroup details beyond the abstract were not reported in the source provided.
## Clinical Analysis & Structured Key Points
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Online ahead of print. # Prevalence of Chronic Complications After Inaugural Admission in Intensive Care Unit for Type 1 Diabetes in the SFDT1 Cohort: The INAUGURAL Study [Emmanuel Cosson](https://pubmed.ncbi.nlm.nih.gov/?term=Cosson+E&cauthor_id=42823888)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#full-view-affiliation-1 "Department of Endocrinology, Diabetology and Nutrition, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris \(AP-HP\), Bobigny, France.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#full-view-affiliation-2 "Clinical Research Center in Human Nutrition \(CRNH-IdF\), Île-de-France Nord Specialized Center for Obesity \(CSO\), University Sorbonne Paris Nord, Bobigny, France.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#full-view-affiliation-3 "Nutritional 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."), [Gloria Aguayo](https://pubmed.ncbi.nlm.nih.gov/?term=Aguayo+G&cauthor_id=42823888)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#full-view-affiliation-4 "Department of Precision Health, Deep Digital Phenotyping Unit, Luxembourg Institute of Health, Strassen, Luxembourg."), [Amandine Créquer-Grandhomme](https://pubmed.ncbi.nlm.nih.gov/?term=Cr%C3%A9quer-Grandhomme+A&cauthor_id=42823888)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#full-view-affiliation-5 "Sanofi, Gentilly, France."), [Amar Bahloul](https://pubmed.ncbi.nlm.nih.gov/?term=Bahloul+A&cauthor_id=42823888)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#full-view-affiliation-5 "Sanofi, Gentilly, France."), [Eric Renard](https://pubmed.ncbi.nlm.nih.gov/?term=Renard+E&cauthor_id=42823888)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#full-view-affiliation-6 "Department of Endocrinology and Diabetology, Montpellier University Hospital, University of Montpellier, INSERM, CNRS, Montpellier, France."), [Louis Potier](https://pubmed.ncbi.nlm.nih.gov/?term=Potier+L&cauthor_id=42823888)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#full-view-affiliation-7 "Department of Diabetology and Endocrinology, Bichat Hospital, Assistance Publique - Hôpitaux de Paris \(AP-HP\), Paris, France.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#full-view-affiliation-8 "INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades, Université Paris Cité, Paris, France."), [Pauline Schaepelynck](https://pubmed.ncbi.nlm.nih.gov/?term=Schaepelynck+P&cauthor_id=42823888)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#full-view-affiliation-9 "Department of Endocrinology and Diabetology, European Hospital, Marseille, France."), [Agnès Sola-Gazagnes](https://pubmed.ncbi.nlm.nih.gov/?term=Sola-Gazagnes+A&cauthor_id=42823888)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#full-view-affiliation-10 "Department of Diabetology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris \(AP-HP\), Paris, France."), [Anne Spiteri](https://pubmed.ncbi.nlm.nih.gov/?term=Spiteri+A&cauthor_id=42823888)[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#full-view-affiliation-11 "Department of Pediatric Endocrinology and Diabetology, Ambulatory Care Platform, Grenoble Alpes University Hospital, Grenoble, France."), [Jean-Pierre Riveline](https://pubmed.ncbi.nlm.nih.gov/?term=Riveline+JP&cauthor_id=42823888)[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#full-view-affiliation-12 "Service de Diabètes et Endocrinologie, Hôpital Lariboisière, AP-HP, Paris, France.")[ 13 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#full-view-affiliation-13 "Équipe Immunité et Métabolisme du Diabète, Université Paris Cité, INSERM UMR-S1151, CNRS UMR-S8253, Institut Necker Enfants Malades, Paris, France."), [Guy Fagherazzi](https://pubmed.ncbi.nlm.nih.gov/?term=Fagherazzi+G&cauthor_id=42823888)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#full-view-affiliation-4 "Department of Precision Health, Deep Digital Phenotyping Unit, Luxembourg Institute of Health, Strassen, Luxembourg.") Affiliations Expand ### Affiliations * 1 Department of Endocrinology, Diabetology and Nutrition, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France. * 2 Clinical Research Center in Human Nutrition (CRNH-IdF), Île-de-France Nord Specialized Center for Obesity (CSO), University Sorbonne Paris Nord, Bobigny, France. * 3 Nutritional 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 Department of Precision Health, Deep Digital Phenotyping Unit, Luxembourg Institute of Health, Strassen, Luxembourg. * 5 Sanofi, Gentilly, France. * 6 Department of Endocrinology and Diabetology, Montpellier University Hospital, University of Montpellier, INSERM, CNRS, Montpellier, France. * 7 Department of Diabetology and Endocrinology, Bichat Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France. * 8 INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades, Université Paris Cité, Paris, France. * 9 Department of Endocrinology and Diabetology, European Hospital, Marseille, France. * 10 Department of Diabetology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France. * 11 Department of Pediatric Endocrinology and Diabetology, Ambulatory Care Platform, Grenoble Alpes University Hospital, Grenoble, France. * 12 Service de Diabètes et Endocrinologie, Hôpital Lariboisière, AP-HP, Paris, France. * 13 Équipe Immunité et Métabolisme du Diabète, Université Paris Cité, INSERM UMR-S1151, CNRS UMR-S8253, Institut Necker Enfants Malades, Paris, France. * PMID: **42823888** * DOI: [ 10.1111/dom.71393 ](https://doi.org/10.1111/dom.71393) Item in Clipboard # Prevalence of Chronic Complications After Inaugural Admission in Intensive Care Unit for Type 1 Diabetes in the SFDT1 Cohort: The INAUGURAL Study Emmanuel Cosson et al. Diabetes Obes Metab. 2026. Show details Display options Display options Format Abstract PubMed PMID Diabetes Obes Metab Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Diabetes+Obes+Metab%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Diabetes+Obes+Metab%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42823888/) . 2026 Oct 2. doi: 10.1111/dom.71393. Online ahead of print. ### Authors [Emmanuel Cosson](https://pubmed.ncbi.nlm.nih.gov/?term=Cosson+E&cauthor_id=42823888)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#short-view-affiliation-1 "Department of Endocrinology, Diabetology and Nutrition, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris \(AP-HP\), Bobigny, France.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#short-view-affiliation-2 "Clinical Research Center in Human Nutrition \(CRNH-IdF\), Île-de-France Nord Specialized Center for Obesity \(CSO\), University Sorbonne Paris Nord, Bobigny, France.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#short-view-affiliation-3 "Nutritional 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."), [Gloria Aguayo](https://pubmed.ncbi.nlm.nih.gov/?term=Aguayo+G&cauthor_id=42823888)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#short-view-affiliation-4 "Department of Precision Health, Deep Digital Phenotyping Unit, Luxembourg Institute of Health, Strassen, Luxembourg."), [Amandine Créquer-Grandhomme](https://pubmed.ncbi.nlm.nih.gov/?term=Cr%C3%A9quer-Grandhomme+A&cauthor_id=42823888)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#short-view-affiliation-5 "Sanofi, Gentilly, France."), [Amar Bahloul](https://pubmed.ncbi.nlm.nih.gov/?term=Bahloul+A&cauthor_id=42823888)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#short-view-affiliation-5 "Sanofi, Gentilly, France."), [Eric Renard](https://pubmed.ncbi.nlm.nih.gov/?term=Renard+E&cauthor_id=42823888)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#short-view-affiliation-6 "Department of Endocrinology and Diabetology, Montpellier University Hospital, University of Montpellier, INSERM, CNRS, Montpellier, France."), [Louis Potier](https://pubmed.ncbi.nlm.nih.gov/?term=Potier+L&cauthor_id=42823888)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#short-view-affiliation-7 "Department of Diabetology and Endocrinology, Bichat Hospital, Assistance Publique - Hôpitaux de Paris \(AP-HP\), Paris, France.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#short-view-affiliation-8 "INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades, Université Paris Cité, Paris, France."), [Pauline Schaepelynck](https://pubmed.ncbi.nlm.nih.gov/?term=Schaepelynck+P&cauthor_id=42823888)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#short-view-affiliation-9 "Department of Endocrinology and Diabetology, European Hospital, Marseille, France."), [Agnès Sola-Gazagnes](https://pubmed.ncbi.nlm.nih.gov/?term=Sola-Gazagnes+A&cauthor_id=42823888)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#short-view-affiliation-10 "Department of Diabetology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris \(AP-HP\), Paris, France."), [Anne Spiteri](https://pubmed.ncbi.nlm.nih.gov/?term=Spiteri+A&cauthor_id=42823888)[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#short-view-affiliation-11 "Department of Pediatric Endocrinology and Diabetology, Ambulatory Care Platform, Grenoble Alpes University Hospital, Grenoble, France."), [Jean-Pierre Riveline](https://pubmed.ncbi.nlm.nih.gov/?term=Riveline+JP&cauthor_id=42823888)[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#short-view-affiliation-12 "Service de Diabètes et Endocrinologie, Hôpital Lariboisière, AP-HP, Paris, France.")[ 13 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#short-view-affiliation-13 "Équipe Immunité et Métabolisme du Diabète, Université Paris Cité, INSERM UMR-S1151, CNRS UMR-S8253, Institut Necker Enfants Malades, Paris, France."), [Guy Fagherazzi](https://pubmed.ncbi.nlm.nih.gov/?term=Fagherazzi+G&cauthor_id=42823888)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42823888/#short-view-affiliation-4 "Department of Precision Health, Deep Digital Phenotyping Unit, Luxembourg Institute of Health, Strassen, Luxembourg.") ### Affiliations * 1 Department of Endocrinology, Diabetology and Nutrition, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France. * 2 Clinical Research Center in Human Nutrition (CRNH-IdF), Île-de-France Nord Specialized Center for Obesity (CSO), University Sorbonne Paris Nord, Bobigny, France. * 3 Nutritional 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 Department of Precision Health, Deep Digital Phenotyping Unit, Luxembourg Institute of Health, Strassen, Luxembourg. * 5 Sanofi, Gentilly, France. * 6 Department of Endocrinology and Diabetology, Montpellier University Hospital, University of Montpellier, INSERM, CNRS, Montpellier, France. * 7 Department of Diabetology and Endocrinology, Bichat Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France. * 8 INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades, Université Paris Cité, Paris, France. * 9 Department of Endocrinology and Diabetology, European Hospital, Marseille, France. * 10 Department of Diabetology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France. * 11 Department of Pediatric Endocrinology and Diabetology, Ambulatory Care Platform, Grenoble Alpes University Hospital, Grenoble, France. * 12 Service de Diabètes et Endocrinologie, Hôpital Lariboisière, AP-HP, Paris, France. * 13 Équipe Immunité et Métabolisme du Diabète, Université Paris Cité, INSERM UMR-S1151, CNRS UMR-S8253, Institut Necker Enfants Malades, Paris, France. * PMID: **42823888** * DOI: [ 10.1111/dom.71393 ](https://doi.org/10.1111/dom.71393) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## 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 obse
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