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Pediatr Diabetes. 2017 Nov;18(7):643-650. doi: 10.1111/pedi.12477. Epub 2016 Nov 23.

Severe hypoglycemia rates are not associated with HbA1c: a cross-sectional analysis of 3 contemporary pediatric diabetes registry databases.

Author information

1
Telethon Kids Institute, The University of Western Australia, Perth, Australia.
2
University of Ulm, ZIBMT, Institute of Epidemiology and Medical Biometry, Ulm, Germany.
3
German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
4
Jaeb Center for Health Research, Tampa, Florida.
5
Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria.
6
Department of Diabetes & Endocrinology, Princess Margaret Hospital, Perth, Australia.
7
Department of Pediatrics, Stanford University, Stanford, California.

Abstract

OBJECTIVE:

To examine the association between glycated hemoglobin (HbA1c) and severe hypoglycemia rates in patients with type 1 diabetes receiving usual care, by analysing data from the US Type 1 Diabetes Exchange (T1DX), German/Austrian Diabetes Patienten Verlaufsdokumenation (DPV), and Western Australian Children Diabetes Database (WACDD) diabetes registries.

METHODS:

Data for patients with type 1 diabetes, aged <18 years with a minimum duration of diabetes of 2 years, were extracted from each registry for a 12-month observation period between 2011 and 2012 (7,102 T1DX, 18,887 DPV, and 865 WACDD). Rates of severe hypoglycemia (self-reported loss of consciousness/convulsion) were estimated per 100 patient-years and analyzed by HbA1c, source registry, treatment regimen, and age group.

RESULTS:

Overall, the severe hypoglycemia rate per 100 patient years was 7.1, 3.3, and 6.7 in T1DX, DPV, and WACDD patients, respectively. Lower HbA1c was not associated with an increased rate of severe hypoglycemia when examined by source registry, treatment regimen, or age group.

CONCLUSION:

An inverse relationship between mean HbA1c and risk of severe hypoglycemia was not observed in this study of 3, independent cohorts of children and adolescents with type 1 diabetes. Investigation in other large, longitudinal cohorts is recommended to further characterize the contemporary relationship between glycemic control and risk of severe hypoglycemia rates in pediatric patients with type 1 diabetes.

KEYWORDS:

adolescent; child; diabetes mellitus; hypoglycemia; registries; type 1

PMID:
27878914
DOI:
10.1111/pedi.12477
[Indexed for MEDLINE]

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