Search: (WFRF:(Charalampopoulos Dimitrios))
> (2018) >
Exploring Variation...
Exploring Variation in Glycemic Control Across and Within Eight High-Income Countries: A Cross-sectional Analysis of 64,666 Children and Adolescents With Type 1 Diabetes
-
- Charalampopoulos, Dimitrios (author)
- UCL, England
-
- Hermann, Julia M. (author)
- Ulm Univ, Germany; German Ctr Diabet Res DZD, Germany
-
- Svensson, Jannet (author)
- Herlev Univ Hosp, Denmark
-
show more...
-
- Skrivarhaug, Torild (author)
- Oslo Univ Hosp, Norway
-
- Maahs, David M. (author)
- Stanford Univ, CA 94305 USA
-
- Åkesson, Karin (author)
- Linköpings universitet,Avdelningen för barns och kvinnors hälsa,Medicinska fakulteten
-
- Warner, Justin T. (author)
- Childrens Hosp Wales, Wales
-
- Holl, Reinhard W. (author)
- Ulm Univ, Germany; German Ctr Diabet Res DZD, Germany
-
- Birkebaek, Niels H. (author)
- Aarhus Univ Hosp, Denmark
-
- Drivvoll, Ann K. (author)
- Oslo Univ Hosp, Norway
-
- Miller, Kellee M. (author)
- Jaeb Ctr Hlth Res, FL USA
-
- Svensson, Ann-Marie (author)
- Ctr Registers Reg Vastra Gotaland, Sweden
-
- Stephenson, Terence (author)
- University College London, London, U.K.
-
- Hofer, Sabine E. (author)
- Med Univ Innsbruck, Austria
-
- Fredheim, Siri (author)
- Herlev University Hospital, Herlev, Denmark
-
- Kummernes, Siv J. (author)
- Oslo Univ Hosp, Norway
-
- Foster, Nicole (author)
- Jaeb Ctr Hlth Res, FL USA
-
- Hanberger, Lena, 1957- (author)
- Linköpings universitet,Avdelningen för omvårdnad,Medicinska fakulteten,Region Östergötland, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus
-
- Amin, Rakesh (author)
- UCL, England
-
- Rami-Merhar, Birgit (author)
- Med Univ Vienna, Austria
-
- Johansen, Anders (author)
- Univ Copenhagen, Denmark
-
- Dahl-Jorgensen, Knut (author)
- Oslo Univ Hosp, Norway; Univ Oslo, Norway
-
- Clements, Mark (author)
- Childrens Mercy Hosp, MO 64108 USA; Univ Missouri Kansas City, MO USA; Univ Kansas, KS 66103 USA
-
- Hanås, Ragnar, 1951 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics
-
show less...
-
(creator_code:org_t)
- 2018-04-12
- 2018
- English.
-
In: Diabetes Care. - : AMER DIABETES ASSOC. - 0149-5992 .- 1935-5548. ; 41:6, s. 1180-1187
- Related links:
-
https://care.diabete...
-
show more...
-
https://urn.kb.se/re...
-
https://doi.org/10.2...
-
https://gup.ub.gu.se...
-
show less...
Abstract
Subject headings
Close
- OBJECTIVE International studies on childhood type 1 diabetes (T1D) have focused on whole-country mean HbA(1c) levels, thereby concealing potential variations within countries. We aimed to explore the variations in HbA(1c) across and within eight high-income countries to best inform international benchmarking and policy recommendations. RESEARCH DESIGN AND METHODS Data were collected between 2013 and 2014 from 64,666 children with T1D who were amp;lt; 18 years of age across 528 centers in Germany, Austria, England, Wales, U.S., Sweden, Denmark, and Norway. We used fixed-and random-effects models adjusted for age, sex, diabetes duration, and minority status to describe differences between center means and to calculate the proportion of total variation in HbA(1c) levels that is attributable to between-center differences (intraclass correlation [ICC]). We also explored the association between within-center variation and childrens glycemic control. RESULTS Sweden had the lowest mean HbA(1c) (59mmol/mol [7.6%]) and together with Norway and Denmark showed the lowest between-center variations (ICC amp;lt;= 4%). Germany and Austria had the next lowest mean HbA(1c) (61-62 mmol/mol [7.7-7.8%]) but showed the largest center variations (ICC similar to 15%). Centers in England, Wales, and the U.S. showed low-to-moderate variation around high mean values. In pooled analysis, differences between counties remained significant after adjustment for children characteristics and center effects (P value amp;lt; 0.001). Across all countries, children attending centers with more variable glycemic results had higher HbA(1c) levels (5.6mmol/mol [0.5%] per 5mmol/mol [0.5%] increase in center SD of HbA(1c) values of all children attending a specific center). CONCLUSIONS A tsimilar average levels of HbA(1c), countries display different levels of center variation. The distribution of glycemic achievement within countries should be considered in developing informed policies that drive quality improvement.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
To the university's database
- By the author/editor
-
Charalampopoulos ...
-
Hermann, Julia M ...
-
Svensson, Jannet
-
Skrivarhaug, Tor ...
-
Maahs, David M.
-
Åkesson, Karin
-
show more...
-
Warner, Justin T ...
-
Holl, Reinhard W ...
-
Birkebaek, Niels ...
-
Drivvoll, Ann K.
-
Miller, Kellee M ...
-
Svensson, Ann-Ma ...
-
Stephenson, Tere ...
-
Hofer, Sabine E.
-
Fredheim, Siri
-
Kummernes, Siv J ...
-
Foster, Nicole
-
Hanberger, Lena, ...
-
Amin, Rakesh
-
Rami-Merhar, Bir ...
-
Johansen, Anders
-
Dahl-Jorgensen, ...
-
Clements, Mark
-
Hanås, Ragnar, 1 ...
-
show less...
- About the subject
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Health Sciences
-
and Public Health Gl ...
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Clinical Medicin ...
-
and Endocrinology an ...
- Articles in the publication
-
Diabetes Care
- By the university
-
Linköping University
-
University of Gothenburg