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 Bargiota; C Sampanis; V Cherubini; R Gesuita; I Strele; S Pildava; K J Coppell; G Magee; J G Cooper; S F Dinneen; K Eeg-Olofsson; A-M Svensson; S Gudbjornsdottir; H Veeze; H-J Aanstoot; M Khalangot; W V Tamborlane; K M Miller

doi:10.1111/dme.12676

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, J G Cooper, S F Dinneen, K Eeg-Olofsson, A-M Svensson, S Gudbjornsdottir, H Veeze, H-J Aanstoot, M Khalangot, W V Tamborlane, K M Miller

Institut for Klinisk Medicin

183 Citationer (Scopus)

Abstract

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 HbA_1c < 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 HbA_1c 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 HbA_1c 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.

Originalsprog	Engelsk
Tidsskrift	Diabetic Medicine
Vol/bind	32
Udgave nummer	8
Sider (fra-til)	1036-50
Antal sider	15
ISSN	0742-3071
DOI	https://doi.org/10.1111/dme.12676
Status	Udgivet - aug. 2015

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McKnight, J. A., Wild, S. H., Lamb, M. J. E., Cooper, M. N., Jones, T. W., Davis, E. A., Hofer, S., Fritsch, M., Schober, E., Svensson, J., Almdal, T., Young, R., Warner, J. T., Delemer, B., Souchon, P. F., Holl, R. W., Karges, W., Kieninger, D. M., Tigas, S., ... Miller, K. M. (2015). Glycaemic control of Type 1 diabetes in clinical practice early in the 21st century: an international comparison. Diabetic Medicine, 32(8), 1036-50. https://doi.org/10.1111/dme.12676

McKnight, JA, Wild, SH, Lamb, MJE, Cooper, MN, Jones, TW, Davis, EA, Hofer, S, Fritsch, M, Schober, E, Svensson, J , Almdal, T, Young, R, Warner, JT, Delemer, B, Souchon, PF, Holl, RW, Karges, W, Kieninger, DM, Tigas, S, Bargiota, A, Sampanis, C, Cherubini, V, Gesuita, R, Strele, I, Pildava, S, Coppell, KJ, Magee, G, Cooper, JG, Dinneen, SF, Eeg-Olofsson, K, Svensson, A-M, Gudbjornsdottir, S, Veeze, H, Aanstoot, H-J, Khalangot, M, Tamborlane, WV & Miller, KM 2015, 'Glycaemic control of Type 1 diabetes in clinical practice early in the 21st century: an international comparison', Diabetic Medicine, bind 32, nr. 8, s. 1036-50. https://doi.org/10.1111/dme.12676

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title = "Glycaemic control of Type 1 diabetes in clinical practice early in the 21st century: an international comparison",

abstract = "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.",

keywords = "Adolescent, Adult, Austria, Denmark, Diabetes Mellitus, Type 1, England, Female, France, Germany, Greece, Guideline Adherence, Hemoglobin A, Glycosylated, Humans, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Ireland, Italy, Latvia, Male, Netherlands, New Zealand, Northern Ireland, Norway, Practice Guidelines as Topic, Registries, Scotland, Sweden, Ukraine, United States, Wales, Western Australia, Young Adult",

author = "McKnight, {J A} and Wild, {S H} and Lamb, {M J E} and Cooper, {M N} and Jones, {T W} and Davis, {E A} and S Hofer and M Fritsch and E Schober and J Svensson and T Almdal and R Young and Warner, {J T} and B Delemer and Souchon, {P F} and Holl, {R W} and W Karges and Kieninger, {D M} and S Tigas and A Bargiota and C Sampanis and V Cherubini and R Gesuita and I Strele and S Pildava and Coppell, {K J} and G Magee and Cooper, {J G} and Dinneen, {S F} and K Eeg-Olofsson and A-M Svensson and S Gudbjornsdottir and H Veeze and H-J Aanstoot and M Khalangot and Tamborlane, {W V} and Miller, {K M}",

note = "{\textcopyright} 2014 The Authors. Diabetic Medicine {\textcopyright} 2014 Diabetes UK.",

year = "2015",

month = aug,

doi = "10.1111/dme.12676",

language = "English",

volume = "32",

pages = "1036--50",

journal = "Diabetic Medicine",

issn = "0742-3071",

publisher = "Wiley-Blackwell",

number = "8",

}

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 - Cooper, J 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

PY - 2015/8

Y1 - 2015/8

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.

KW - Adolescent

KW - Adult

KW - Austria

KW - Denmark

KW - Diabetes Mellitus, Type 1

KW - England

KW - Female

KW - France

KW - Germany

KW - Greece

KW - Guideline Adherence

KW - Hemoglobin A, Glycosylated

KW - Humans

KW - Hypoglycemic Agents

KW - Insulin

KW - Insulin Infusion Systems

KW - Ireland

KW - Italy

KW - Latvia

KW - Male

KW - Netherlands

KW - New Zealand

KW - Northern Ireland

KW - Norway

KW - Practice Guidelines as Topic

KW - Registries

KW - Scotland

KW - Sweden

KW - Ukraine

KW - United States

KW - Wales

KW - Western Australia

KW - Young Adult

U2 - 10.1111/dme.12676

DO - 10.1111/dme.12676

M3 - Journal article

C2 - 25510978

SN - 0742-3071

VL - 32

SP - 1036

EP - 1050

JO - Diabetic Medicine

JF - Diabetic Medicine

IS - 8

ER -

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

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