Glycaemic control of Type 1 diabetes in clinical practice early in the 21st century: An international comparison

J. A. Mcknight*, S. H. Wild, M. J E Lamb, M. N. Cooper, T. W. Jones, E. A. Davis, S. Hofer, M. Fritsch, E. Schober, J. Svensson, T. Almdal, R. Young, J. T. Warner, B. Delemer, P. F. Souchon, R. W. Holl, W. Karges, D. M. Kieninger, S. Tigas, A. BargiotaC. Sampanis, V. Cherubini, R. Gesuita, I. Strele, S. Pildava, K. J. Coppell, G. Magee, S. F. Dinneen, K. Eeg-Olofsson, A. M. Svensson, S. Gudbjornsdottir, H. Veeze, H. J. Aanstoot, M. Khalangot, W. V. Tamborlane, K. M. Miller, behalf of the a Scottish Diabetes Research Network Epidemiology Group on behalf of the a Scottish Diabetes Research Network Epidemiology Group, DPV database German/Austria DPV database, Pediatric Diabetes Audit National Pediatric Diabetes Audit, DIAB Network CARe DIAB Network, Study Group RIDI Study Group, University Hospitals Department of Diabetes Endocrinology Galway University Hospitals Department of Diabetes Endocrinology, Diabetes Register in Sweden National Diabetes Register in Sweden, Diabetes Register Team Ukrainian Diabetes Register Team, Exchange Clinic Network T1D Exchange Clinic Network

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)1036-1050
Number of pages15
JournalDiabetic Medicine
Issue number8
Publication statusPublished - 2015

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