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

Regina Prigge¹, John A McKnight^{1

2}, Sarah H Wild¹, Aveni Haynes³, Timothy W Jones^{3

4

5}, Elizabeth A Davis^{3

4

5}, Birgit Rami-Merhar⁶, Maria Fritsch^{6

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 Laatikainen^{16

17

18}, Päivi Rautiainen¹⁸, Brigitte Delemer¹⁹, Pierre François Souchon²⁰, Alpha M Diallo¹⁹, Reinhard W Holl^{21

22}, Sebastian M Schmid^{22

23}, Klemens Raile²⁴, Stelios Tigas²⁵, Alexandra Bargiota²⁶, Ioanna Zografou²⁷, Andrea O Y Luk²⁸, Juliana C N Chan²⁹, Sean F Dinneen^{30

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 Battelino^{40

41}, Klemen Dovc^{40

41}, Nataša Bratina^{40

41}, Katarina Eeg-Olofsson^{42

43}, Ann-Marie Svensson^{43

44}, Soffia Gudbjornsdottir^{43

44}, Evgenia Globa⁴⁵, Nataliya Zelinska⁴⁵

Affiliations

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.

PMID: 34890078
DOI: 10.1111/dme.14766

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

Regina Prigge et al. Diabet Med. 2022 May.

. 2022 May;39(5):e14766.

doi: 10.1111/dme.14766. Epub 2021 Dec 26.

Authors

Affiliations

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.

PMID: 34890078
DOI: 10.1111/dme.14766

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 HbA_1c (IQR) and proportions of individuals with HbA_1c < 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 HbA_1c < 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 HbA_1c category compared to previous estimates were calculated.

Results: Median HbA_1c 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 HbA_1c < 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 HbA_1c < 58 mmol/l (<7.5%) increased and proportions of people with HbA_1c ≥ 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.

Keywords: HbA1c; glycaemic control; registers of people with diabetes; type 1 diabetes.

PubMed Disclaimer

References

REFERENCES

1. Nathan DM, DCCT/EDIC Research Group. The diabetes control and complications trial/epidemiology of diabetes interventions and complications study at 30 years: overview. Diabetes Care. 2014;37:9-16.
1. American Diabetes Association. Standards of medical care in diabetes-2013. Diabetes Care. 2013;36:S11-S66.
1. IDF/ISPAD. 2011 Global Guideline for Diabetes in Childhood and Adolescence. 2013.
1. Scottish Intercollegiate Guidelines Network. Management of Diabetes: A National Clinical Guideline. Scottish Intercollegiate Guidelines Network; 2017. Accessed December 22, 2021. https://www.sign.ac.uk/assets/sign116.pdf
1. American Diabetes Association. 6. Glycemic targets: standards of medical care in diabetes-2020. Diabetes Care. 2020; 43:S66-S76.

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Substances

Actions
Actions

LinkOut - more resources

Full Text Sources
- Ovid Technologies, Inc.
- Wiley
Medical
- MedlinePlus Health Information
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

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

Affiliations

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

Authors

Affiliations

Abstract

References

REFERENCES

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous