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Diabetes Technol Ther. 2019 Feb;21(2):66-72. doi: 10.1089/dia.2018.0384. Epub 2019 Jan 18.

State of Type 1 Diabetes Management and Outcomes from the T1D Exchange in 2016-2018.

Author information

1
1 Jaeb Center for Health Research, Tampa, Florida.
2
2 Endocrine/Diabetes Department, Children's Mercy Hospital, Kansas City, Missouri.
3
3 Rodebaugh Diabetes Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
4
4 Department of Pediatrics, Indiana University School of Medicine, Indianapolis Indiana.
5
5 Department of Pediatrics-Endocrinology, Stanford University, Stanford, California.
6
6 Pediatric Endocrinology and Diabetes, Yale University School of Medicine, New Haven, Connecticut.
7
7 International Diabetes Center Park Nicollet, Minneapolis, Minnesota.
8
8 Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado.

Erratum in

Abstract

OBJECTIVE:

To provide a snapshot of the profile of adults and youth with type 1 diabetes (T1D) in the United States and assessment of longitudinal changes in T1D management and clinical outcomes in the T1D Exchange registry.

RESEARCH DESIGN AND METHODS:

Data on diabetes management and outcomes from 22,697 registry participants (age 1-93 years) were collected between 2016 and 2018 and compared with data collected in 2010-2012 for 25,529 registry participants.

RESULTS:

Mean HbA1c in 2016-2018 increased from 65 mmol/mol at the age of 5 years to 78 mmol/mol between ages 15 and 18, with a decrease to 64 mmol/mol by age 28 and 58-63 mmol/mol beyond age 30. The American Diabetes Association (ADA) HbA1c goal of <58 mmol/mol for youth was achieved by only 17% and the goal of <53 mmol/mol for adults by only 21%. Mean HbA1c levels changed little between 2010-2012 and 2016-2018, except in adolescents who had a higher mean HbA1c in 2016-2018. Insulin pump use increased from 57% in 2010-2012 to 63% in 2016-2018. Continuous glucose monitoring (CGM) increased from 7% in 2010-2012 to 30% in 2016-2018, rising >10-fold in children <12 years old. HbA1c levels were lower in CGM users than nonusers. Severe hypoglycemia was most frequent in participants ≥50 years old and diabetic ketoacidosis was most common in adolescents and young adults. Racial differences were evident in use of pumps and CGM and HbA1c levels.

CONCLUSIONS:

Data from the T1D Exchange registry demonstrate that only a minority of adults and youth with T1D in the United States achieve ADA goals for HbA1c.

KEYWORDS:

Continuous glucose monitor use; Insulin pump use.; T1D Exchange registry

PMID:
30657336
DOI:
10.1089/dia.2018.0384
[Indexed for MEDLINE]

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