First year national Swedish paediatric Hba1c data are at the level of several intervention studies: Results from a Swedish nationwide diabetes register study

IF 6.1 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM
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Abstract

Aims/hypothesis

To study the progression of HbA1c after diagnosis of type 1 diabetes in children and adolescents during 2010–2019 with emphasis on HbA1c nadir 3–6 months after onset.

Methods

Partial funding was secured for this study. The Swedish paediatric diabetes quality register SWEDIABKIDS has >95 % coverage of type 1 diabetes up to 18 years. A mixed model for repeated measurements was used to estimate differences in HbA1c between onset year periods.

Results

We followed 6,891 patients over two years from onset (48,292 HbA1c values). We found a gradual decrease in mean HbA1c 24 months after onset from 56.0 mmol/mol (7.28 %) in 2010/11 to 50.5 mmol/mol (6.77 %) in 2018/19, which is at the level of several recent intervention studies. The initial drop in HbA1c from onset until 3 and 6 months has become more pronounced in recent years. There was a significant positive correlation between HbA1c at 3 and 6 months with 12, 18 and 24 months. Percentage of severe hypoglycaemic coma was higher (5.1 % vs 3.4 %; p = 0.023) in 2010/2011 than 2018/2019, but the absolute risk of ketoacidosis was essentially unchanged, (1.5 % to 0.8 %, p = 0.110)

Conclusions/interpretation

There was a continuous decrease in HbA1c over the study period 2010–2019, which coincides in time with an increased use of diabetes technology and lowering the HbA1c target to 48 mmol/mol (6.5 %). The decrease in 2-year HbA1c was preceded by a lower HbA1c nadir, which may set the trajectories for coming HbA1c and be a modifiable factor for a long-term improvement in metabolic control.

瑞典全国儿科 Hba1c 的第一年数据达到了多项干预研究的水平:瑞典全国糖尿病登记研究的结果。
目的/假设:研究 2010-2019 年间儿童和青少年确诊 1 型糖尿病后 HbA1c 的进展情况,重点是发病后 3-6 个月的 HbA1c 最低值:本研究获得了部分资助。瑞典儿科糖尿病质量登记册 SWEDIABKIDS 对 18 岁以下 1 型糖尿病患者的覆盖率大于 95%。研究采用重复测量混合模型来估计发病年份之间 HbA1c 的差异:我们对 6891 名患者进行了为期两年的跟踪调查(48,292 个 HbA1c 值)。我们发现,发病 24 个月后,平均 HbA1c 值逐渐下降,从 2010/11 年的 56.0 mmol/mol(7.28%)降至 2018/19 年的 50.5 mmol/mol(6.77%),达到了近期几项干预研究的水平。从发病到 3 个月和 6 个月,HbA1c 的初始降幅近年来变得更加明显。3 个月和 6 个月时的 HbA1c 与 12 个月、18 个月和 24 个月时的 HbA1c 呈明显正相关。2010/2011 年严重低血糖昏迷的百分比高于 2018/2019 年(5.1 % vs 3.4 %;p = 0.023),但酮症酸中毒的绝对风险基本未变,(1.5 % 至 0.8 %,p = 0.110)结论/解释。在2010-2019年的研究期间,HbA1c持续下降,这与糖尿病技术的使用增加以及HbA1c目标值降至48 mmol/mol(6.5%)的时间相吻合。在两年期 HbA1c 下降之前,HbA1c 最低点较低,这可能为未来 HbA1c 的下降设定了轨迹,也是长期改善代谢控制的一个可调节因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diabetes research and clinical practice
Diabetes research and clinical practice 医学-内分泌学与代谢
CiteScore
10.30
自引率
3.90%
发文量
862
审稿时长
32 days
期刊介绍: Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.
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