Treatment intensification without improved HbA_1c levels in children and adolescents with Type 1 diabetes mellitus

Abstract

Intensifying treatment alone does not lead to improved metabolic control in the overall population despite the appearance of lower HbA1c in individuals with a greater number of self-monitored blood glucose measurements and injections/boluses. The contradictory results reflect difficulties in using observational studies to predict results of intervention in the individual. Data collected from population-based registries need to be adjusted continuously to reflect changes in care.

High frequencies of dermatological complications in children using insulin pumps or sensors

“…The incidence of type 1 diabetes (T1D) in children is increasing in Denmark and other western countries . During the last 10 years, the treatment of Danish children with diabetes has shifted toward more intensive treatment regimens with more patients using continuous subcutaneous insulin infusion (CSII), often combined with continuous glucose monitoring (CGM) . More intensive treatment with either CSII or multiple daily insulin injections (MDI) can reduce the risk of long‐term complications .…”

“…1 During the last 10 years, the treatment of Danish children with diabetes has shifted toward more intensive treatment regimens with more patients using continuous subcutaneous insulin infusion (CSII), often combined with continuous glucose monitoring (CGM). 2 More intensive treatment with either CSII or multiple daily insulin injections (MDI) can reduce the risk of long-term complications. 3,4 CSII also stabilizes physiological blood glucose levels, improves glycemic control, lowers the risk of severe hypoglycemia, and improves quality of life scores.…”

The influence of treatment, age at onset, and metabolic control on height in children and adolescents with type 1 diabetes—A SWEET collaborative study

“…Insulin levels are associated with both IGF‐1 and IGF1BP3 levels and, in particular, low insulin levels in the portal vein are known to impair growth. The increasing use of pump treatment during the last decades may have contributed to more physiologic levels of insulin . This may have a positive effect on growth in children with T1D.…”

Interventions using pediatric diabetes registry data for quality improvement: A systematic review

“…One of the Swedish studies (Reference ) reports on the extension of a previous study (Reference ). Two studies report data from the same Swedish registry (References ) and another 2 studies report data from the same Norwegian registry (References ); both pairs of studies have over‐lapping study periods (Table ).…”