TY - JOUR
T1 - Glycaemic control of Type 1 diabetes in clinical practice early in the 21st century
T2 - An international comparison
AU - Mcknight, J. A.
AU - Wild, S. H.
AU - Lamb, M. J E
AU - Cooper, M. N.
AU - Jones, T. W.
AU - Davis, E. A.
AU - Hofer, S.
AU - Fritsch, M.
AU - Schober, E.
AU - Svensson, J.
AU - Almdal, T.
AU - Young, R.
AU - Warner, J. T.
AU - Delemer, B.
AU - Souchon, P. F.
AU - Holl, R. W.
AU - Karges, W.
AU - Kieninger, D. M.
AU - Tigas, S.
AU - Bargiota, A.
AU - Sampanis, C.
AU - Cherubini, V.
AU - Gesuita, R.
AU - Strele, I.
AU - Pildava, S.
AU - Coppell, K. J.
AU - Magee, G.
AU - Dinneen, S. F.
AU - Eeg-Olofsson, K.
AU - Svensson, A. M.
AU - Gudbjornsdottir, S.
AU - Veeze, H.
AU - Aanstoot, H. J.
AU - Khalangot, M.
AU - Tamborlane, W. V.
AU - Miller, K. M.
AU - on behalf of the a Scottish Diabetes Research Network Epidemiology Group, behalf of the a Scottish Diabetes Research Network Epidemiology Group
AU - German/Austria DPV database, DPV database
AU - National Pediatric Diabetes Audit, Pediatric Diabetes Audit
AU - CARe DIAB Network, DIAB Network
AU - RIDI Study Group, Study Group
AU - Galway University Hospitals Department of Diabetes Endocrinology, University Hospitals Department of Diabetes Endocrinology
AU - National Diabetes Register in Sweden, Diabetes Register in Sweden
AU - Ukrainian Diabetes Register Team, Diabetes Register Team
AU - T1D Exchange Clinic Network, Exchange Clinic Network
PY - 2015
Y1 - 2015
N2 - Aims: Improving glycaemic control in people with Type 1 diabetes is known to reduce complications. Our aim was to compare glycaemic control among people with Type 1 diabetes using data gathered in regional or national registries. Methods: Data were obtained for children and/or adults with Type 1 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 173 880. Proportions with HbA1c < 58 mmol/mol (< 7.5%) and ≥ 75 mmol/mol (≥ 9.0%) were compared by age and sex. Results: Data were available for 324 501 people. The proportions with HbA1c 58 mmol/mol (< 7.5%) varied from 15.7% to 46.4% among 44 058 people aged < 15 years, from 8.9% to 49.5% among 50 766 people aged 15-24 years and from 20.5% to 53.6% among 229 677 people aged ≥ 25 years. Sex differences in glycaemic control were small. Proportions of people using insulin pumps varied between the 12 sources with data available. Conclusion: These results suggest that there are substantial variations in glycaemic control among people with Type 1 diabetes between the data sources and that there is room for improvement in all populations, especially in young adults. What's new?: We present HbA1c data from registries in 19 different countries describing control in 324 501 people with Type 1 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 Type 1 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.
AB - Aims: Improving glycaemic control in people with Type 1 diabetes is known to reduce complications. Our aim was to compare glycaemic control among people with Type 1 diabetes using data gathered in regional or national registries. Methods: Data were obtained for children and/or adults with Type 1 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 173 880. Proportions with HbA1c < 58 mmol/mol (< 7.5%) and ≥ 75 mmol/mol (≥ 9.0%) were compared by age and sex. Results: Data were available for 324 501 people. The proportions with HbA1c 58 mmol/mol (< 7.5%) varied from 15.7% to 46.4% among 44 058 people aged < 15 years, from 8.9% to 49.5% among 50 766 people aged 15-24 years and from 20.5% to 53.6% among 229 677 people aged ≥ 25 years. Sex differences in glycaemic control were small. Proportions of people using insulin pumps varied between the 12 sources with data available. Conclusion: These results suggest that there are substantial variations in glycaemic control among people with Type 1 diabetes between the data sources and that there is room for improvement in all populations, especially in young adults. What's new?: We present HbA1c data from registries in 19 different countries describing control in 324 501 people with Type 1 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 Type 1 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.
UR - http://www.scopus.com/inward/record.url?scp=84948716018&partnerID=8YFLogxK
U2 - 10.1111/dme.12676
DO - 10.1111/dme.12676
M3 - Article
C2 - 25510978
AN - SCOPUS:84948716018
SN - 0742-3071
VL - 32
SP - 1036
EP - 1050
JO - Diabetic Medicine
JF - Diabetic Medicine
IS - 8
ER -