Improved metabolic control in children and adolescents with type 1 diabetes: a trend analysis using prospective multicenter data from Germany and Austria. Diabetes Care 2012;35:80–86

Rosenbauer, Joachim; Dost, Axel; Karges, Beate; Hungele, Andreas; Ståhl, Anna; Bächle, Christina; Gerstl, EM; Kastendieck, Christian; Hofer, Susanne; Holl, Reinhard W.

doi:10.2337/dc12-er11b

Cited by 44 publications

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“…In our group of patients, the age at which they were diagnosed with diabetes did not affect the disease's metabolic control or without a statistically significant difference, was found (P. = 0.260) which is in agreement with this study (15)(16)(17) . The duration of type 1 diabetes <= 5 years, in uncontrolled hyperglycemia diabetes patients, was the highest (64.2%), when the mean of age for all subjects is 4.26 ± 3.407 years old, as well in well-controlled T1DM patients <= 5 years was the highest (86.1%) when the mean of age for all subjects is 3.22 ± 3.072 years old, with a statistically significant difference, was found (P. = 0.031) which is in agreement with this study (13) .…”

Section: Table (1) the Basic Socio-demographic Characteristics Of The Study Samplesupporting

confidence: 92%

“…This result shows that well-controlled diabetes in females was higher than in males, which is in agreement with other studies like these by (1,(8)(9)(10)(11) , with no statistically significant difference, was found (P = 0.557). For body mass index, the median with uncontrolled hyperglycemia diabetes T1DM patients (18.48 kg/m2) was significantly less than that in well-controlled diabetes in T1DM patients (18.89 kg/m2), (P. = 0.009), may be associated with uncontrolled hyperglycemia diabetes and corresponds with the studies by (12,13) . The present study found that among the sampled population with uncontrolled hyperglycemia diabetes T1DM patients, 101 (58.4%)…”

Section: Introductionsupporting

confidence: 80%

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Risk Factors of Uncontrolled Hyperglycemia in Children and Adolescents with Type 1 Diabetes Mellitus

Shukur Abdulkareem Mahmood,

Majid A. Maatook,

Dhaigham E. Aatwan

2021

Indian Journal of Forensic Medicine & Toxicology

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Background: In Iraqi children with type 1 diabetes mellitus, glycemic control levels and risk factors for uncontrolled hyperglycemia are unknown. The aim of the study to assess the factors that increase the risk of uncontrolled hyperglycemia in children and adolescents with type 1 diabetes mellitus, and identify levels of glycemic control in children and adolescents with type 1 diabetes mellitus. Methods:A cross-sectional study was carried out from September 21 2020 until the end of May 2021 to identify levels of glycemic control and assess the risk factors of uncontrolled hyperglycemia in children and adolescents with type 1 diabetes mellitus, for the study sample which was 209 type 1 diabetics, selected randomly from the visitors of a Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC). The American Diabetes Association assigned target HbA1c levels to patients based on their age groups. Comparison has been made of well-controlled patients and uncontrolled hyperglycemia patients. To assess each risk factor's role in uncontrolled type 1 diabetes hyperglycemia, the Odds Ratios were calculated.Results: Only 17.2% of children and adolescents with type 1 diabetes mellitus were well-controlled diabetes. Better glycemic control was related to age < 6 years, BMI, and duration of type 1 diabetes <5 years. Glycemic control was not affected by gender, residence, socio-economic status. Conclusion:Type 1 diabetes mellitus glycemic control among children and adolescents in Al-Basra/ southern Iraq varies widely, risking microvascular complications. In well-control type 1 diabetes mellitus patients, females were higher than males and in the age group (1-6) years, higher than the other age groups. While in uncontrolled patients with type 1 diabetes, about (57.2%) had an episode of diabetic ketoacidosis (DKA). The major risk factors for uncontrolled hyperglycemia are excessive sweet intake, fast food, and irregular meals.

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Section: Table (1) the Basic Socio-demographic Characteristics Of The Study Samplesupporting

confidence: 92%

Section: Introductionsupporting

confidence: 80%

Risk Factors of Uncontrolled Hyperglycemia in Children and Adolescents with Type 1 Diabetes Mellitus

Shukur Abdulkareem Mahmood,

Majid A. Maatook,

Dhaigham E. Aatwan

2021

Indian Journal of Forensic Medicine & Toxicology

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“…Diabetes care in general differs not only on an individual basis but also between diabetes centers on a national and even more on an international basis 6–8 . Benchmarking and comparison of diabetes care through diabetes registries improved patient outcomes significantly over the years 9,10 . Furthermore, it raised awareness for differences in diabetes care between countries 6,11–13 .…”

Section: Introductionmentioning

confidence: 99%

Size matters: Influence of center size on quality of diabetes control in children and adolescents with type 1 diabetes—A longitudinal analysis of the DPV cohort

et al. 2021

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Background Treatment of patients with type 1 diabetes requires experience and a specific infrastructure. Therefore, center size might influence outcome in diabetes treatment. Objective To analyze the influence of center size on the quality of diabetes treatment in children and adolescents in Germany and Austria. Patients and methods In 2009 and 2018, we analyzed metabolic control, acute complications, and rates of recommended screening tests in the DPV cohort. Diabetes centers were classified according to the number of patients from “XS” to “XL” (<20 [XS], ≥20 to <50 [S], ≥50 to <100 [M], ≥100 to <200 [L], ≥200 [XL]). Results Over the 10‐year period, metabolic control improved significantly in “M”, “L” and “XL” diabetes centers. Treatment targets are best achieved in “M” centers, while “XS” centers have the highest mean hemoglobin A1c. The relation between hemoglobin A1c and center size follows a “v‐shaped” curve. In 2009, conventional insulin therapy was most frequently used in “XS” centers, but in 2018, there was no difference in mode of insulin therapy according to center size. Use of CSII and sensor augmented CSII/hybrid closed loop increased with center size. Patients cared for in “XS” diabetes centers had the fewest follow‐up visits per year. The rates of severe hypoglycemia and DKA were lowest in “XL” diabetes centers, and the rate of DKA was highest in “XS” centers. Conclusion Center size influences quality of care in pediatric patients with type 1 diabetes. Further investigations regarding contributing factors such as staffing and financial resources are required.

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“…HbA1c was measured locally in each center; to adjust for differences between laboratories, the multiple of the mean method was used to standardize local HbA1c mathematically to the DCCT reference of 20-42 mmol/mol (4-6%). The BMI was calculated from registered height and weight as weight/squared height (kg/m [2]) and converted to BMI-SDS (standard deviation score) using WHO growth curves [16,17]. Blood pressure was assessed according to Fourth Report [18] ("Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents").…”

Section: Data Source and Participantsmentioning

confidence: 99%

The Association between Treatment Modality, Lipid Profile, Metabolic Control in Children with Type 1 Diabetes and Celiac Disease—Data from the International Sweet Registry

et al. 2021

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Background and Aims: A higher frequency of dyslipidemia is reported in children with type 1 diabetes (T1D) and celiac disease (CD). Recently, continuous subcutaneous insulin infusion (CSII) has been associated with better lipid profiles in patients with T1D. The aim of this study was to investigate the association between treatment modality and lipid profile, metabolic control, and body mass index (BMI)-SDS in children with both T1D and CD. Methods: Cross-sectional study in children registered in the international SWEET database in November 2020. Inclusion criteria were children (2–18 years) with T1D and CD with available data on treatment modality (CSII and injections therapy, IT), triglyceride, total cholesterol, HDL, LDL, dyslipidemia, HbA1c, and BMI-SDS. Overweight/obesity was defined as > +1 BMI-SDS for age. Data were analyzed by linear and logistical regression models with adjustment for age, gender, and diabetes duration. Results: In total 1009 children with T1D and CD (female 54%, CSII 54%, age 13.9 years ±3.6, diabetes duration 7.2 years ±4.1, HbA1c 7.9% ±1.4) were included. Significant differences between children treated with CSII vs. IT were respectively found; HDL 60.0 mg/dL vs. 57.8 mg/dL, LDL 89.4 mg/dL vs. 94.2 mg/dL, HbA1c 7.7 vs. 8.1%, BMI-SDS 0.4 vs. 0.6, overweight and obesity 17% vs. 26% (all p < 0.05). Conclusions: CSII is associated with higher HDL and lower LDL, HbA1c, BMI-SDS, and percentage of overweight and obesity compared with IT in this study. Further prospective studies are required to determine whether CSII improves lipid profile, metabolic control and normalize body weight in children with both T1D and CD.

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Improved metabolic control in children and adolescents with type 1 diabetes: a trend analysis using prospective multicenter data from Germany and Austria. Diabetes Care 2012;35:80–86

Cited by 44 publications

References 0 publications

Risk Factors of Uncontrolled Hyperglycemia in Children and Adolescents with Type 1 Diabetes Mellitus

Risk Factors of Uncontrolled Hyperglycemia in Children and Adolescents with Type 1 Diabetes Mellitus

Size matters: Influence of center size on quality of diabetes control in children and adolescents with type 1 diabetes—A longitudinal analysis of the DPV cohort

The Association between Treatment Modality, Lipid Profile, Metabolic Control in Children with Type 1 Diabetes and Celiac Disease—Data from the International Sweet Registry

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