Mahira Saiyed1, Dhruvi Hasnani2, G Todd Alonso3, Erick Richmond4, Stéphane Besançon5, Andrew Cotterill6, Ursula Ngwu7, Carmen Mazza8, Diane Rottembourg9, Stefanie Lanzinger10,11. 1. Diacare- Diabetes Care & Hormone Clinic, Ahmedabad, India. 2. Diacare at Ratan Hospital, Ahmedabad, India. 3. Barbara Davis Center for Diabetes, Denver, Colorado, USA. 4. National Children's Hospital, Hospital CIMA, San Jose, Costa Rica. 5. Service d'endocrinologie et diabétologie, NGO Santé Diabète, Hopital du Mali, Bamako, Mali. 6. Queensland Paediatric Endocrinology, Brisbane, Queensland, Australia. 7. Sherwood Forest Hospital NHS, Mansfield, UK. 8. Unit of Nutrition Hospital Juan P. Garrahan, Buenos Aires, Argentina. 9. Sherbrooke University Hospital, Sherbrooke, Quebec, Canada. 10. Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Germany. 11. German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany.
Abstract
OBJECTIVE: To study worldwide differences in childhood diabetes, comparing relevant indicators among five regions within the SWEET initiative. SUBJECTS: We investigated 26 726 individuals with type 1 diabetes (T1D) from 54 centers in the European region; 7768 individuals from 30 centers in the Asia/Middle East/Africa region; 2642 people from five centers in Australia/New Zealand; 10 839 individuals from seven centers in North America, and 1114 patients from five centers in South America. METHODS: The SWEET database was analyzed based on the following inclusion criteria: T1D, time period 2015-2019, and age < 21 years, with analysis of the most recent documented year of therapy. For the statistical analysis, we used multivariable linear and logistic regression models to adjust for age (<6 years, 6- < 12 years, 12- < 18 years, 18- < 21 years), gender, and duration of diabetes (<2 years, 2- < 5 years, 5- < 10 years, ≥10 years). RESULTS: Adjusted HbA1c means ranged from 7.8% (95%-confidence interval: 7.6-8.1) in Europe to 9.5% (9.2-9.8) in Asia/Middle East/Africa. Mean daily insulin dose ranged from 0.8 units/kg in Europe (0.7-0.8) and Australia/New Zealand (0.6-0.9) to 1.0 unit/kg 0.9-1.1) in Asia/Middle East/Africa. Percentage of pump use was highest in North America (80.7% [79.8-81.6]) and lowest in South America (4.2% [3.2-5.6]). Significant differences between the five regions were also observed with regards to body mass index SD scores, frequency of blood glucose monitoring and presence of severe hypoglycaemia. CONCLUSIONS: We found significant heterogeneity in diabetes care and outcomes across the five regions. The aim of optimal care for each child remains a challenge.
OBJECTIVE: To study worldwide differences in childhood diabetes, comparing relevant indicators among five regions within the SWEET initiative. SUBJECTS: We investigated 26 726 individuals with type 1 diabetes (T1D) from 54 centers in the European region; 7768 individuals from 30 centers in the Asia/Middle East/Africa region; 2642 people from five centers in Australia/New Zealand; 10 839 individuals from seven centers in North America, and 1114 patients from five centers in South America. METHODS: The SWEET database was analyzed based on the following inclusion criteria: T1D, time period 2015-2019, and age < 21 years, with analysis of the most recent documented year of therapy. For the statistical analysis, we used multivariable linear and logistic regression models to adjust for age (<6 years, 6- < 12 years, 12- < 18 years, 18- < 21 years), gender, and duration of diabetes (<2 years, 2- < 5 years, 5- < 10 years, ≥10 years). RESULTS: Adjusted HbA1c means ranged from 7.8% (95%-confidence interval: 7.6-8.1) in Europe to 9.5% (9.2-9.8) in Asia/Middle East/Africa. Mean daily insulin dose ranged from 0.8 units/kg in Europe (0.7-0.8) and Australia/New Zealand (0.6-0.9) to 1.0 unit/kg 0.9-1.1) in Asia/Middle East/Africa. Percentage of pump use was highest in North America (80.7% [79.8-81.6]) and lowest in South America (4.2% [3.2-5.6]). Significant differences between the five regions were also observed with regards to body mass index SD scores, frequency of blood glucose monitoring and presence of severe hypoglycaemia. CONCLUSIONS: We found significant heterogeneity in diabetes care and outcomes across the five regions. The aim of optimal care for each child remains a challenge.
Authors: Marco Marigliano; Andrea E Scaramuzza; Riccardo Bonfanti; Ivana Rabbone; Riccardo Schiaffini; Sonia Toni; Valentino Cherubini Journal: JAMA Netw Open Date: 2022-08-01
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Authors: Alise A van Heerwaarde; Renz C W Klomberg; Conny M A van Ravenswaaij-Arts; Hans Kristian Ploos van Amstel; Aartie Toekoen; Fariza Jessurun; Abhimanyu Garg; Daniëlle C M van der Kaay Journal: J Clin Endocrinol Metab Date: 2021-11-19 Impact factor: 5.958