Priya Prahalad1,2, Anke Schwandt3,4, Stéphane Besançon5, Meena Mohan6, Barbora Obermannova7, Melanie Kershaw8, Riccardo Bonfanti9, Auste Pundziute Lyckå10, Ragnar Hanas11,12, Kristina Casteels13,14. 1. Division of Pediatric Endocrinology, Stanford University, Stanford, California, USA. 2. Stanford Diabetes Research Center, Stanford, California, USA. 3. Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, Ulm, Germany. 4. German Centre for Diabetes Research (DZD), Neuherberg, Germany. 5. NGO Santé Diabète Headquarter France and Delegation in Mali, Grenoble, France. 6. Department of Endocrinology, PSG Super Speciality Hospitals, Coimbatore, India. 7. Department of Pediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic. 8. Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK. 9. Pediatric Diabetes, Diabetes Research Institute, Ospedale San Raffaele Milano, Milan, Italy. 10. Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden. 11. Department of Pediatrics, NU Hospital Group, Uddevalla, Sweden. 12. Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. 13. Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium. 14. Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
Abstract
AIM: A majority of youth with type 1 diabetes do not meet recommended hemoglobin A1c (HbA1c) targets. The SWEET diabetes registry is a multi-national registry of youth with diabetes. We used data from this registry to identify characteristics associated with glycemic control. METHODS: Patients in the SWEET diabetes registry with at least one HbA1c value within 10 days of diagnosis and three follow up measurements in the first 18 months of diagnosis were included (~10% of the SWEET diabetes registry). Locally weighted scatterplot smoothing was used to generate curves of HbA1c. Wilcoxon, Kruskal-Wallis, or χ2-tests were used to calculate differences between groups. RESULTS: The mean HbA1c of youth in the SWEET diabetes registry is highest at diagnosis and lowest between months 4 and 5 post-diabetes diagnosis. HbA1c continues to increase steadily through the first 18 months of diagnosis. There are no differences in HbA1c trajectories based on sex or use of diabetes technology. Youth in North America/Australia/New Zealand had the highest HbA1c throughout the first 18 months of diagnosis. The trajectory of youth from countries with nationalized health insurance was lower than those countries without nationalized health insurance. Youth from countries with the highest gross domestic product (GDP) had the highest HbA1c throughout the first 18 months of diagnosis. CONCLUSIONS: In this subset of patients, the trajectory of youth from countries with nationalized health insurance was lower than those countries without nationalized health insurance. High GDP and high use of technology did not seem to protect from a higher trajectory.
AIM: A majority of youth with type 1 diabetes do not meet recommended hemoglobin A1c (HbA1c) targets. The SWEET diabetes registry is a multi-national registry of youth with diabetes. We used data from this registry to identify characteristics associated with glycemic control. METHODS: Patients in the SWEET diabetes registry with at least one HbA1c value within 10 days of diagnosis and three follow up measurements in the first 18 months of diagnosis were included (~10% of the SWEET diabetes registry). Locally weighted scatterplot smoothing was used to generate curves of HbA1c. Wilcoxon, Kruskal-Wallis, or χ2-tests were used to calculate differences between groups. RESULTS: The mean HbA1c of youth in the SWEET diabetes registry is highest at diagnosis and lowest between months 4 and 5 post-diabetes diagnosis. HbA1c continues to increase steadily through the first 18 months of diagnosis. There are no differences in HbA1c trajectories based on sex or use of diabetes technology. Youth in North America/Australia/New Zealand had the highest HbA1c throughout the first 18 months of diagnosis. The trajectory of youth from countries with nationalized health insurance was lower than those countries without nationalized health insurance. Youth from countries with the highest gross domestic product (GDP) had the highest HbA1c throughout the first 18 months of diagnosis. CONCLUSIONS: In this subset of patients, the trajectory of youth from countries with nationalized health insurance was lower than those countries without nationalized health insurance. High GDP and high use of technology did not seem to protect from a higher trajectory.
Authors: Ulrike Schierloh; Gloria A Aguayo; Anna Schritz; Muriel Fichelle; Cindy De Melo Dias; Michel T Vaillant; Ohad Cohen; Inge Gies; Carine de Beaufort Journal: Front Endocrinol (Lausanne) Date: 2022-05-31 Impact factor: 6.055