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Diabet Med. 2015 Aug;32(8):1036-50. doi: 10.1111/dme.12676. Epub 2015 Feb 21.

Glycaemic control of Type 1 diabetes in clinical practice early in the 21st century: an international comparison.

Author information

1
Metabolic Unit, Western General Hospital, Edinburgh and University of Edinburgh, UK.
2
Scottish Diabetes Research Network Epidemiology Group.
3
Centre for Population Health Sciences, University of Edinburgh, UK.
4
Telethon Kids Institute, The University of Western Australia, Perth, Australia.
5
Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Australia.
6
School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia.
7
Department of Pediatrics, Medical University of Innsbruck, Austria.
8
German/Austria DPV database.
9
Department of Pediatrics, Medical University of Vienna, Austria.
10
Department of Pediatrics, Copenhagen University Hospital Herlev, Denmark.
11
Department of Medicine F, Copenhagen University Hospital, Hellerup, Denmark.
12
Salford Royal Foundation NHS Trust, Salford, UK.
13
Children's Hospital for Wales, Cardiff, UK.
14
National Pediatric Diabetes Audit and the Royal College of Paediatrics and Child Health.
15
Department of Endocrinology, Diabetes and Nutrition, American Memorial Hospital, University Hospital of Rheims, France.
16
Department of Pediatrics, American Memorial Hospital, University Hospital of Rheims, France.
17
CARéDIAB Network.
18
Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Germany.
19
Division of Endocrinology, RWTH Aachen University, Germany.
20
Diabetes Division, Department of Paediatrics, Universitätsmedizin Johannes Gutenberg Universität Mainz, Germany.
21
Department of Endocrinology, University of Ioannina, Greece.
22
Department of Endocrinology and Metabolic Diseases, University of Thessaly, Greece.
23
Second Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokratio General Hospital, Thessaloniki, Greece.
24
Department of Women's and Children's Health, SalesiHospital, Ancona, Italy.
25
RIDI Study Group.
26
Centre of Epidemiology and Biostatistics, Polytechnic University of Marche, Italy.
27
Department of Public Health and Epidemiology, Riga Stradins University, Riga, Latvia.
28
The Centre for Disease Prevention and Control of Latvia, Riga, Latvia.
29
Edgar Diabetes and Obesity Research, Department of Medicine, University of Otago, Dunedin, New Zealand.
30
Daisy Hill Hospital, Newry, County Down, UK.
31
Norwegian Adult Diabetes Register, Noklus, Bergen, Norway.
32
Galway University Hospitals, Galway, Ireland.
33
NUI Galway, Galway, Ireland.
34
Galway University Hospitals Department of Diabetes, Endocrinology and Metabolism.
35
Department of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Göteborg, Sweden.
36
National Diabetes Register in Sweden.
37
Centre of Registers in Region VöstraGötaland, Göteborg, Sweden.
38
Diabeter, National Centre for Pediatric and Adolescent Diabetes, Rotterdam, the Netherlands.
39
Shupyk National Medical Academy of Postgraduate Education and Komisarenko Institute of Endocrinology and Metabolism, Kiev, Ukraine.
40
Ukrainian Diabetes Register Team.
41
Yale University, New Haven, CT, USA.
42
T1D Exchange Clinic Network.
43
Jaeb Centre for Health Research, Tampa, FL, USA.

Abstract

AIMS:

Improving glycaemic control in people with Type 1 diabetes is known to reduce complications. Our aim was to compare glycaemic control among people with Type 1 diabetes using data gathered in regional or national registries.

METHODS:

Data were obtained for children and/or adults with Type 1 diabetes from the following countries (or regions): Western Australia, Austria, Denmark, England, Champagne-Ardenne (France), Germany, Epirus, Thessaly and Thessaloniki (Greece), Galway (Ireland), several Italian regions, Latvia, Rotterdam (The Netherlands), Otago (New Zealand), Norway, Northern Ireland, Scotland, Sweden, Volyn (Ukraine), USA and Wales) from population or clinic-based registries. The sample size with available data varied from 355 to 173 880. Proportions with HbA1c < 58 mmol/mol (< 7.5%) and ≥ 75 mmol/mol (≥ 9.0%) were compared by age and sex.

RESULTS:

Data were available for 324 501 people. The proportions with HbA1c 58 mmol/mol (< 7.5%) varied from 15.7% to 46.4% among 44 058 people aged < 15 years, from 8.9% to 49.5% among 50 766 people aged 15-24 years and from 20.5% to 53.6% among 229 677 people aged ≥ 25 years. Sex differences in glycaemic control were small. Proportions of people using insulin pumps varied between the 12 sources with data available.

CONCLUSION:

These results suggest that there are substantial variations in glycaemic control among people with Type 1 diabetes between the data sources and that there is room for improvement in all populations, especially in young adults.

PMID:
25510978
DOI:
10.1111/dme.12676
[Indexed for MEDLINE]

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