Regina Prigge1, John A McKnight1,2, Sarah H Wild1, Aveni Haynes3, Timothy W Jones3,4,5, Elizabeth A Davis3,4,5, Birgit Rami-Merhar6, Maria Fritsch6,7, Christine Prchla8, Astrid Lavens9, Kris Doggen9, Suchsia Chao9, Ronnie Aronson10, Ruth Brown10, Else H Ibfelt11, Jannet Svensson12, Robert Young13, Justin T Warner14, Holy Robinson15, Tiina Laatikainen16,17,18, Päivi Rautiainen18, Brigitte Delemer19, Pierre François Souchon20, Alpha M Diallo19, Reinhard W Holl21,22, Sebastian M Schmid22,23, Klemens Raile24, Stelios Tigas25, Alexandra Bargiota26, Ioanna Zografou27, Andrea O Y Luk28, Juliana C N Chan29, Sean F Dinneen30,31, Claire M Buckley32, Oratile Kgosidialwa30, Valentino Cherubini33, Rosaria Gesuita34, Ieva Strele35, Santa Pildava36, Henk Veeze37, Henk-Jan Aanstoot37, Dick Mul37, Craig Jefferies38, John G Cooper39, Karianne Fjeld Løvaas39, Tadej Battelino40,41, Klemen Dovc40,41, Nataša Bratina40,41, Katarina Eeg-Olofsson42,43, Ann-Marie Svensson43,44, Soffia Gudbjornsdottir43,44, Evgenia Globa45, Nataliya Zelinska45. 1. Usher Institute, University of Edinburgh, Edinburgh, UK. 2. Metabolic Unit and Acute Receiving Unit, Western General Hospital, Edinburgh, UK. 3. Telethon Kids Institute, The University of Western Australia, Perth, Australia. 4. Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, Australia. 5. School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia. 6. Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria. 7. Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria. 8. Klinik Donaustadt, Department of Paediatrics and Adolescent Medicine, Vienna, Austria. 9. Sciensano, Brussels, Belgium. 10. LMC Diabetes & Endocrinology, Toronto, Canada. 11. Steno Diabetes Center Copenhagen, Gentofte, Denmark. 12. Department of Paediatrics, Copenhagen University Hospital Herlev, Copenhagen, Denmark. 13. Diabetes UK, London, UK. 14. Children's Hospital for Wales, Cardiff, UK. 15. Royal College of Paediatrics and Child Health, London, UK. 16. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. 17. National Institute for Health and Welfare, Helsinki, Uusimaa, Finland. 18. Joint municipal authority for North Karelia social and health services (Siunsote), Joensuu, Finland. 19. Department of Endocrinology, Diabetes and Nutrition, American Memorial Hospital, University Hospital of Reims, Reims, France. 20. Department of Paediatrics, American Memorial Hospital, University Hospital of Reims, Reims, France. 21. Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany. 22. German Centre for Diabetes Research (DZD), Neuherberg, Germany. 23. Institute for Endocrinology and Diabetes, University of Lübeck, Lübeck, Germany. 24. Department of Paediatric Endocrinology and Diabetology, University Medicine Berlin, CharitéBerlin, Germany. 25. Department of Endocrinology, University of Ioannina, Ioannina, Greece. 26. Department of Endocrinology and Metabolic Diseases, University of Thessaly, Volos, Greece. 27. Second Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokratio General Hospital, Thessaloniki, Greece. 28. Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong Institute of Diabetes and Obesity, Hong Kong, China. 29. The Chinese University of Hong Kong, Li Ka Shing Institute of Health Science, Hong Kong, China. 30. Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospital, Galway, Ireland. 31. NUI Galway, Galway, Ireland. 32. School of Public Health, University College Cork, Cork, Ireland. 33. Department of Women's and Children's Health, Salesi Hospital, Ancona, Italy. 34. Centre of Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, Italy, Italy. 35. Department of Public Health and Epidemiology, Riga Stradins University, Riga, Latvia. 36. The Centre for Disease Prevention and Control of Latvia, Riga, Latvia. 37. Diabeter, National Centre for Paediatric and Adolescent Diabetes, Rotterdam, the Netherlands. 38. Department of Endocrinology, Starship Children's Health, Auckland, New Zealand. 39. Norwegian Diabetes Register for Adults, Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway. 40. Department of Paediatric Endocrinology, Diabetes and Metabolic Diseases, UMC - University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia. 41. Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. 42. Department of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden. 43. Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden. 44. Centre of Registers in Region VästraGötaland, Göteborg, Sweden. 45. Ukrainian Research Centre of Endocrine Surgery, Endocrine Organs and Tissue Transplantation, MoH of Ukraine, Kyiv, Ukraine.
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.
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.
Authors: Stuart J McGurnaghan; Luke A K Blackbourn; Thomas M Caparrotta; Joseph Mellor; Anna Barnett; Andy Collier; Naveed Sattar; John McKnight; John Petrie; Sam Philip; Robert Lindsay; Katherine Hughes; David McAllister; Graham P Leese; Ewan R Pearson; Sarah Wild; Paul M McKeigue; Helen M Colhoun Journal: BMJ Open Date: 2022-10-12 Impact factor: 3.006