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. 2021 May;180(5):1513-1520.
doi: 10.1007/s00431-020-03891-2. Epub 2021 Jan 7.

Lower HbA1c targets are associated with better metabolic control

Marlies Van Loocke  1 , Tadej Battelino  2   3 , Sascha R Tittel  4   5 , Priya Prahalad  6 , Damla Goksen  7 , Elizabeth Davis  8 , Kristina Casteels  9   10 ; SWEET study group
Affiliations

Lower HbA1c targets are associated with better metabolic control

Marlies Van Loocke et al. Eur J Pediatr. 2021 May.

Abstract

Previous studies have suggested that clear HbA1c target setting by the diabetes team is associated with HbA1c outcomes in adolescents. The aim of this study was to evaluate whether this finding is consistent in a larger cohort of children from centers participating in the SWEET international diabetes registry. A questionnaire was sent out to 76 SWEET centers, of which responses from 53 pediatric centers were included (70%). Descriptive outcomes were presented as median with lower and upper quartile. The association between the centers' target HbA1c and mean outcome HbA1c was calculated using linear regression adjusted for age, diabetes duration, sex, and gross domestic product. Median age of the children in the studied centers (n = 35,483) was 13.3 [12.6-14.6] years (49% female). Of the 53 centers, 13.2% reported an HbA1c target between 6.0 and 6.5%, 32.1% had a target between ≥ 6.0 and 7.0%, 18.9% between ≥ 7.0 and 7.5%, and 3.8% between ≥ 7.5 and 8.5%. No specific target value was reported by 32.1% of all centers. Median HbA1c across all centers was 7.9 [7.6-8.3] %. Adjusted regression analysis showed a positive association between HbA1c outcome and target HbA1c (p = 0.005).Conclusions: This international study demonstrated that a lower target for HbA1c was associated with better metabolic control. It is unclear whether low target values result in better metabolic control, or lower HbA1c values actually result in more ambitious target values. This target setting could contribute to the differences in HbA1c values between centers and could be an approach for improving metabolic outcomes. What is Known: • Target setting of HbA1c is important in children and adolescents with type 1 diabetes. • The optimal therapeutic approach of children with type 1 diabetes requires a trained multidisciplinary team. What is New: • Lower HbA1c targets are associated with better metabolic control. • No associations between the composition of the diabetes teams and metabolic control could be demonstrated.

Keywords: Children; HbA1c; Metabolic control; SWEET.

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References

    1. Unnikrishnan R, Shah V, Mohan V (2016) Challenges in diagnosis and management of diabetes in the young. Clin Diab Endocrinol 2:18 - DOI
    1. Mortensen H (2002) Findings from the Hvidoere Study Group on childhood diabetes: metabolic controle and quality of life. Hormone Res 57(suppl 1):117–120 - DOI
    1. Laron Z, Galatzer A, Amir S et al (1979) A multidisciplinary comprehensive ambulatory treatment scheme for diabetes mellitus in children. Diabetes Care 2:342–348 - DOI
    1. Danne T, Mortensen HB, Hougaard P et al (2001) Persistent differences among centers over 3 years in glycemic control and hypoglycemia in a study of 3805 children and adolescents with type 1 diabetes from the Hvidore study group. Diabetes Care 24(8):1342–1347 - DOI
    1. DiMeglio LA, Acerini CL, Codner E et al (2018) Chapter 8: Glycemic control targets and glucose monitoring for children, adolescents and young adults with diabetes. In: ISPAD Clinical Practice Consensus Guidelines

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