| 2. |
- Prigge, R., et al.
(författare)
-
International comparison of glycaemic control in people with type 1 diabetes: an update and extension
- 2022
-
Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 39:5
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: To update and extend a previous cross-sectional international comparison of glycaemic control in people with type 1 diabetes. Methods: Data were obtained for 520,392 children and adults with type 1 diabetes from 17 population and five clinic-based data sources in countries or regions between 2016 and 2020. Median HbA1c(IQR) and proportions of individuals with HbA1c < 58 mmol/mol (<7.5%), 58–74 mmol/mol (7.5–8.9%) and ≥75 mmol/mol (≥9.0%) were compared between populations for individuals aged <15, 15–24 and ≥25 years. Logistic regression was used to estimate the odds ratio (OR) of HbA1c < 58 mmol/mol (<7.5%) relative to ≥58 mmol/mol (≥7.5%), stratified and adjusted for sex, age and data source. Where possible, changes in the proportion of individuals in each HbA1c category compared to previous estimates were calculated. Results: Median HbA1c varied from 55 to 79 mmol/mol (7.2 to 9.4%) across data sources and age groups so a pooled estimate was deemed inappropriate. OR (95% CI) for HbA1c< 58 mmol/mol (<7.5%) were 0.91 (0.90–0.92) for women compared to men, 1.68 (1.65–1.71) for people aged <15 years and 0.81 (0.79–0.82) aged15–24 years compared to those aged ≥25 years. Differences between populations persisted after adjusting for sex, age and data source. In general, compared to our previous analysis, the proportion of people with an HbA1c < 58 mmol/l (<7.5%) increased and proportions of people with HbA1c≥ 75 mmol/mol (≥9.0%) decreased. Conclusions: Glycaemic control of type 1 diabetes continues to vary substantially between age groups and data sources. While some improvement over time has been observed, glycaemic control remains sub-optimal for most people with Type 1 diabetes.
|
|
| 3. |
- McKnight, J. A., et al.
(författare)
-
Glycaemic control of Type1 diabetes in clinical practice early in the 21st century: an international comparison
- 2015
-
Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071. ; 32:8, s. 1036-1050
-
Tidskriftsartikel (refereegranskat)abstract
- AimsImproving glycaemic control in people with Type1 diabetes is known to reduce complications. Our aim was to compare glycaemic control among people with Type1 diabetes using data gathered in regional or national registries. MethodsData were obtained for children and/or adults with Type1 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 173880. Proportions with HbA(1c) <58mmol/mol (<7.5%) and 75mmol/mol (9.0%) were compared by age and sex. ResultsData were available for 324501 people. The proportions with HbA(1c) 58mmol/mol (<7.5%) varied from 15.7% to 46.4% among 44058 people aged <15years, from 8.9% to 49.5% among 50766 people aged 15-24years and from 20.5% to 53.6% among 229677 people aged 25years. Sex differences in glycaemic control were small. Proportions of people using insulin pumps varied between the 12 sources with data available. ConclusionThese results suggest that there are substantial variations in glycaemic control among people with Type1 diabetes between the data sources and that there is room for improvement in all populations, especially in young adults. We present HbA(1c) data from registries in 19 different countries describing control in 324501 people with Type1 diabetes, across all age groups. These data are the best representation of diabetes care available and therefore describe the state of the art'. We show clearly that Type1 diabetes control is not as good as suggested in guidelines, but that some healthcare systems appear to result in better control than others. These data present a challenge to diabetes services. Leaders in diabetes units/service can compare their local data to our data and encourage improvement.
|
|
