TOPLINE:

Among individuals aged 15-34 years with newly diagnosed type 1 diabetes (T1D), plasma uric acid levels were significantly higher in those who later developed diabetes-related complications and were independently associated with subsequent macrovascular and microvascular diseases. Screening for uric acid at diagnosis could therefore help identify high‑risk individuals who might benefit from more intensive primary prevention.

METHODOLOGY:

• Researchers in Sweden analysed uric acid levels in individuals aged 15-34 years with newly diagnosed T1D from a nationwide cohort to determine whether those levels are associated with future macrovascular and microvascular complications.
• Individuals were followed up for a median duration of 19 years.
• A total of 94 individuals (mean age at diagnosis, 26.7 years; 50% women; median A1c levels during follow-up, 8.2%) who developed at least one diabetes-related complication during follow-up were matched with 94 control individuals without complications on the basis of age at diagnosis, sex, year of diagnosis, and A1c levels.
• Data on complications, including microalbuminuria, macroalbuminuria, nephropathy, cardiac disease, stroke, peripheral vascular disease, neuropathy, and retinopathy (excluding simplex retinopathy), were collected.
• Plasma uric acid levels were categorised into quartiles, with the highest quartile corresponding to > 217 μmol/L and the lowest quartile corresponding to < 180 μmol/L.

TAKEAWAY:

• Plasma uric acid levels at diabetes diagnosis were significantly higher in individuals who later developed complications than in those who did not (P < .001).
• Each 1 μmol/L increase in baseline uric acid levels was associated with a 1% rise in the odds of developing complications.
• Individuals in the highest uric acid quartile had 3.68 (95% CI, 1.26-10.71) times the odds of future complications compared with those in the lowest uric acid quartile after adjusting for age, smoking, A1c levels, and estimated glomerular filtration rate.
• When comparing the highest and lowest uric acid quartiles, the odds ratio was 4.13 (95% CI, 1.34-12.78) for microvascular complications and 9.26 (95% CI, 2.14-40.15) for macrovascular complications.

IN PRACTICE:

"[The study finding] indicates that screening for UA [uric acid] in new-onset type 1 diabetes might become a tool for identifying high-risk individuals who will benefit from a more aggressive primary preventive treatment," the authors of the study wrote.

SOURCE:

This study was led by Katarina Fagher, Lund University, Lund, Sweden. It was published online on October 14, 2025, in Diabetologia.

LIMITATIONS:

Although matching was attempted for sex, A1c levels, age at diagnosis, and year of diagnosis, only sex was perfectly matched. The cohort's relatively young age resulted in a low incidence of major macrovascular and microvascular complications. The observational design precluded establishing a causal relationship between baseline uric acid levels and subsequent complications.

DISCLOSURES:

This study received funding through unrestricted grants from Sweden's Southern Healthcare Region, the Skåne University Hospital, Sydvästra Skånes Diabetesförening, and Faculty of Medicine at Lund University, Sweden. Some authors reported receiving honoraria for consulting and/or lecture fees from various pharmaceutical companies outside the submitted work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.