Higher Uric Acid at Diagnosis Linked to Complications in Young T1DM Patients: Study
A new study published in the journal of Diabetologia showed that both macrovascular and microvascular problems in later life may be associated with elevated baseline uric acid (UA) levels at the time of type 1 diabetes diagnosis.
Cardiovascular disease (CVD) risk is still around twice as high in those with diabetes as in the general population, even with optimum metabolic management. Type 1 diabetes causes significant loss of life years, even though type 2 diabetes accounts for the majority of CVD occurrences.
This extra risk is only partially explained by traditional risk variables, which highlight the need to find more early predictors. There is little information on the involvement of uric acid, an end product of purine metabolism, in the early stages of type 1 diabetes, but it has been connected to vascular problems and death.
To close this gap, this research looked at UA levels at diagnosis in people from Sweden's countrywide Diabetes Incidence Study who were 15–34 years old and had recently been diagnosed with type 1 diabetes. They then assessed their relationship to later macrovascular and microvascular problems.
UA levels were examined in the statewide Diabetes Incidence Study in Sweden (DISS) cohort of people aged 15–34 who had just been diagnosed with type 1 diabetes to determine the association with macro- and microvascular problems in later life. Record linking to Sweden's National Diabetes Registry and National Patient Registry provided information on complications. persons who experienced difficulties during follow-up (n = 94) were matched with control persons (n = 94) who did not have complications for year, age at diagnosis (±2 years), sex, and HbA1c.
After a median follow-up of 19.0 years (IQR 16.3–21.0), plasma UA levels at the time of diabetes diagnosis were substantially higher in those who later experienced diabetes-related problems than in those who did not: 209.2 ± 68.9 vs. 171.7 ± 50.2 µmol/l (p<0.001). After controlling for age, HbA1c, smoking, and eGFR, people in the highest quartile of UA were more than three times more likely to have diabetes-related problems later in life.
The risks of having difficulties increased by 1% for every 1 μmol/l increase in baseline UA. Overall, higher baseline UA levels at the time of type 1 diabetes diagnosis may be associated with both macrovascular and microvascular problems in later life, according to this data. To look for the possible impact of reducing UA on the chances of future problems, clinical studies are required.
Reference:
Fagher, K., Eeg-Olofsson, K., Arnqvist, H., Bolinder, J., Eriksson, J. W., Gudbjörnsdottir, S., Nyström, L., & Landin-Olsson, M. (2026). Uric acid and future complications in young individuals with type 1 diabetes: results from the Diabetes Incidence Study in Sweden (DISS) and the National Diabetes Registry of Sweden (NDR). Diabetologia, 69(1), 50–58. https://doi.org/10.1007/s00125-025-06561-w
