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

Department of Clinical Medicine

183 Citations (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.

Original language	English
Journal	Diabetic Medicine
Volume	32
Issue number	8
Pages (from-to)	1036-50
Number of pages	15
ISSN	0742-3071
DOIs	https://doi.org/10.1111/dme.12676
Publication status	Published - Aug 2015

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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1111/dme.12676

Cite this

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, vol. 32, no. 8, pp. 1036-50. https://doi.org/10.1111/dme.12676

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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.",

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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",

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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