International comparison of glycaemic control in people with type 1 diabetes: an update and extension

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Date
2021-12-10
Authors
Prigge, R.
McKnight, J. A.
Wild, S. H.
Haynes, A.
Jones, T. W.
Davis, E. A.
Rami-Merhar, B.
Fritsch, M.
Prchla, Christine
Lavens, A.
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John Wiley & Sons, Inc.
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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<58mmol/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 ≥ 25years. 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.
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Keywords
Type 1 diabetes , Glycaemic control , HbA1c , Registers of people with diabetes
Citation
Prigge, R., McKnight, J. A., Wild, S. H., Haynes, A., Jones, T. W., Davis, E. A., Rami-Merhar, B., Fritsch, M., Prchla, C., Lavens, A., Doggen, K., Chao, S., Aronson, R., Brown, R., Ibfelt, E. H., Svensson, J., Young, R., Warner, J. T., Robinson, H., Laatikainen, T., Rautiainen, P., Delemer, B., Souchon, P. F., Diallo, A. M. , Holl, R., Schmid, S., Raile, K., Tigas, S., Bargiota, A., Zografou, I., Luk, A. O. Y., Chan, J. C. N., Dinneen, S. F., Buckley, C. M., Kgosidialwa, O., Cherubini, V., Gesuita, R., Strele, I., Pildava, S., Veeze, H., Aanstoot, H.-J., Mul, D., Jefferies, C., Cooper, J. G., Fjeld Løvaas, K., Battelino, T., Dovc, K., Bratina, N., Eeg-Olofsson, K., Svensson, A.-M., Gudbjornsdottir, S., Globa, E. and Zelinska, N. (2021) ‘International comparison of glycaemic control in people with type 1 diabetes: an update and extension’, Diabetic Medicine, e14766. doi: 10.1111/dme.14766
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© 2021, John Wiley & Sons Ltd. This is the peer reviewed version of the following item: Prigge, R., McKnight, J. A., Wild, S. H., Haynes, A., Jones, T. W., Davis, E. A., Rami-Merhar, B., Fritsch, M., Prchla, C., Lavens, A., Doggen, K., Chao, S., Aronson, R., Brown, R., Ibfelt, E. H., Svensson, J., Young, R., Warner, J. T., Robinson, H., Laatikainen, T., Rautiainen, P., Delemer, B., Souchon, P. F., Diallo, A. M. , Holl, R., Schmid, S., Raile, K., Tigas, S., Bargiota, A., Zografou, I., Luk, A. O. Y., Chan, J. C. N., Dinneen, S. F., Buckley, C. M., Kgosidialwa, O., Cherubini, V., Gesuita, R., Strele, I., Pildava, S., Veeze, H., Aanstoot, H.-J., Mul, D., Jefferies, C., Cooper, J. G., Fjeld Løvaas, K., Battelino, T., Dovc, K., Bratina, N., Eeg-Olofsson, K., Svensson, A.-M., Gudbjornsdottir, S., Globa, E. and Zelinska, N. (2021) ‘International comparison of glycaemic control in people with type 1 diabetes: an update and extension’, Diabetic Medicine, e14766. doi: 10.1111/dme.14766, which has been published in final form at: https://doi.org/10.1111/dme.14766 This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.