Above 40% of Polish children and young adults with type 1 diabetes achieve international HbA1c target ‐ results of a nationwide cross‐sectional evaluation of glycemic control: The PolPeDiab HbA1c study

Abstract

Background Youth with type 1 diabetes (T1D) (16–18 y.o.) present worst disease control of all age groups and need structured interventions. Those should be based on unbiased, national‐scale outcomes, which have not yet been successfully assessed in Poland. Objective To evaluate the glycemic control in young patients with T1D in Poland. Method All pediatric diabetes care centers and the nine largest centers for adults with T1D were invited to this cross‐sectional study, conducted in March 2018. Eligibility was defined as age ≤ 30 years and diabetes duration ≥1 year. Blinded samples of capillary blood and clinical questionnaires were sent to coordinating center, where HbA1c was measured by high‐pressure liquid chromatography. Results Nine adult and 25/28 pediatric centers participated, providing data for 1255 patients (50.8% males), mean age 12.3 years (95%CI:12.1–12.6) for children and 23.2 years (22.9–23.6) for adults; mean diabetes duration 7.1 years (6.8–7.3). This covered ~8% of pediatric population and 2% of 18–30‐years‐olds with T1D. Mean HbA1c was comparable between children and adults (57 mmol/mol [7.4%], 95%CI:56‐57 mmol/mol [7.3–7.4%] vs. 57 mmol/mol [7.4%], 95%CI:56–60 mmol/mol [7.3–7.6%], p = 0.1870). Overall, 45.2% of patients achieved ISPAD target (<53 mmol/mol [<7.0%]). During the month preceding the study, 0.9% of patients experienced severe hypoglycemia and 0.4% suffered ketoacidosis. HbA1c was related to the method of insulin therapy, continuous glucose monitoring use and body weight (p < 0.0001). Conclusions In Polish children and young adults with T1D glycemic control expressed as HbA1c is promising in the light of ISPAD guidelines. Our results confirm the known associations between better glycemic control and the use of new technologies and maintaining optimal body weight.

Prospective Open-Label, Single-Arm, Single-Center Follow-Up Study of the Application of the Advanced Hybrid Closed Loop System in Well-Controlled Children and Adolescents with Type 1 Diabetes

“… 25 , 26 Furthermore, our observations are consistent with the results of the PolPeDiab HbA1c study, a nationwide cross-sectional evaluation of glycemic control, in which the ISPAD target for HbA1c was achieved by up to 45.2% of 1255 Polish children with type 1 diabetes. 27 …”

GlyCulator 3.0: A Fast, Easy-to-Use Analytical Tool for CGM Data Analysis, Aggregation, Center Benchmarking, and Data Sharing

“…Its detailed description, results, and a step-by-step manual for results reproduction, including all required anonymized patient files, are provided on the software’s website ( https://glyculator.btm.umed.pl/ ). Such benchmarks provide essential insight into diabetes care quality and may help with identification of areas that need improvement ( 3 , 4 ).…”