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Metabolic outcomes in young children with type 1 diabetes differ between treatment centers : the Hvidoere Study in Young Children 2009
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- de Beaufort, Carine E. (author)
- Pediat Clin, Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg
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- Lange, Karin (author)
- Dept Med Psychol, Hannover Medical School, Hannover, Germany
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- Swift, Peter G. F. (author)
- Childrens Hosp, Leicester Royal Infirmary, Leicester, England.
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- Åman, Jan (author)
- Region Örebro län,Dept Pediat, Örebro University Hospital, Örebro, Sweden
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- Cameron, Fergus (author)
- Dept Endocrinol & Diabet, Royal Childrens Hosp, Parkville Vic, Australia
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- Castano, Luis (author)
- Endocrinol & Diabet Res Grp, Hosp Cruces, Univ Basque Country, Baracaldo, Spain
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- Dorchy, Harry (author)
- Diabetol Clin, Univ Hosp Reine Fabiola, Brussels, Belgium
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- Fisher, Lynda K. (author)
- Dept Endocrinol & Diabet, Childrens Hosp Los Angeles, Los Angeles CA, USA.
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- Hoey, Hilary (author)
- Natl Childrens Hosp, Univ Dublin Trinity Coll, Dublin, Ireland
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- Kaprio, Eero (author)
- Dept Paediat, Peijas Hosp, Helsinki, Finland
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- Kocova, Mirjana (author)
- Dept Endocrinol & Genet, Univ Pediat Clin, Skopje, Macedonia
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- Neu, Andreas (author)
- Clin Children & Adolescence, Univ Tubingen, Tubingen, Germany
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- Njolstad, Pal R. (author)
- Dept Clin Med, Univ Bergen, Bergen, Norway; Dept Pediat, Haukeland Hosp, Bergen, Norway
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- Phillip, Moshe (author)
- Natl Ctr Childhood Diabet, Schneiders Med Ctr Israel, Petah Tiqwa, Israel
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- Schoenle, Eugen (author)
- Dept Diabet & Endocrinol, Univ Childrens Hosp, Zurich, Switzerland
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- Robert, Jean J. (author)
- Dept Childhood & Adolescent Diabet, Hop Necker Enfants Malad, Paris, France
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- Urukami, Tatsuhiko (author)
- Sch Med, Nihon Univ, Tokyo, Japan
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- Vanelli, Maurizio (author)
- Pediat Clin, Ctr Diabetol, Parma, Italy
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- Danne, Thomas (author)
- Krankenhaus Bult, Hannover, Germany
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- Barrett, Tim (author)
- Inst Child Hlth, Univ Birmingham, Birmingham, England; Birmingham Childrens Hosp, Univ Birmingham, Birmingham, England
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- Chiarelli, Franco (author)
- Pediat Clin, Osped Policlin, Chieti, Italy
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- Aanstoot, Henk J. (author)
- Ctr Pediat & Adolescent Diabet Care & Res, Rotterdam, Netherlands
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- Mortensen, Henrik B. (author)
- Herlev Hosp, Dept Pediat, Herlev, Denmark; Fac Hlth Sci, Univ Copenhagen, Copenhagen, Denmark
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(creator_code:org_t)
- 2012-09-10
- 2013
- English.
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In: Pediatric Diabetes. - : Hindawi Limited. - 1399-543X .- 1399-5448. ; 14:6, s. 422-428
- Related links:
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https://orbilu.uni.l...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Objective: To investigate whether center differences in glycemic control are present in prepubertal children <11yr with type 1 diabetes mellitus. Research Design and Methods: This cross-sectional study involved 18 pediatric centers worldwide. All children, <11 y with a diabetes duration 12months were invited to participate. Case Record Forms included information on clinical characteristics, insulin regimens, diabetic ketoacidosis (DKA), severe hypoglycemia, language difficulties, and comorbidities. Hemoglobin A1c (HbA1c) was measured centrally by liquid chromatography (DCCT aligned, range: 4.4-6.3%; IFFC: 25-45mmol/mol). Results: A total of 1133 children participated (mean age: 8.0 +/- 2.1 y; females: 47.5%, mean diabetes duration: 3.8 +/- 2.1 y). HbA1c (overall mean: 8.0 +/- 1.0%; range: 7.3-8.9%) and severe hypoglycemia frequency (mean 21.7 events per 100 patient-years), but not DKA, differed significantly between centers (p<0.001 resp. p=0.179). Language difficulties showed a negative relationship with HbA1c (8.3 +/- 1.2% vs. 8.0 +/- 1.0%; p = 0.036). Frequency of blood glucose monitoring demonstrated a significant but weak association with HbA1c (r=-0.17; p<0.0001). Although significant different HbA1c levels were obtained with diverse insulin regimens (range: 7.3-8.5%; p<0.001), center differences remained after adjusting for insulin regimen (p<0.001). Differences between insulin regimens were no longer significant after adjusting for center effect (p=0.199). Conclusions: Center differences in metabolic outcomes are present in children <11yr, irrespective of diabetes duration, age, or gender. The incidence of severe hypoglycemia is lower than in adolescents despite achieving better glycemic control. Insulin regimens show a significant relationship with HbA1c but do not explain center differences. Each center's effectiveness in using specific treatment strategies remains the key factor for outcome.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
Keyword
- children
- glycemic control
- HbA1c
- type 1 diabetes mellitus
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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de Beaufort, Car ...
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Lange, Karin
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Swift, Peter G. ...
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Åman, Jan
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Cameron, Fergus
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Castano, Luis
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Dorchy, Harry
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Fisher, Lynda K.
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Hoey, Hilary
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Kaprio, Eero
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Kocova, Mirjana
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Neu, Andreas
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Njolstad, Pal R.
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Phillip, Moshe
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Schoenle, Eugen
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Robert, Jean J.
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Urukami, Tatsuhi ...
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Vanelli, Maurizi ...
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Danne, Thomas
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Barrett, Tim
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Chiarelli, Franc ...
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Aanstoot, Henk J ...
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Mortensen, Henri ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Endocrinology an ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Pediatrics
- Articles in the publication
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Pediatric Diabet ...
- By the university
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Örebro University