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Improved metabolic outcome in a Danish diabetic paediatric population aged 0-18 yr: results from a nationwide

Jannet Svensson1, Jesper Johannesen, Henrik B Mortensen

  • 1Paediatric department, Glostrup University Hospital, Nordre Ringvej, 2600 Glostrup, Denmark. js@dsbd.dk

Pediatric Diabetes
|January 30, 2009
PubMed

Insights

Glycaemic control in children with type 1 diabetes improved significantly between 1996 and 2006. Increased self-monitoring of blood glucose and fewer hypoglycaemic events were key factors in this metabolic control enhancement.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Diabetes Research

Background:

  • Childhood diabetes management presents unique challenges.
  • Long-term glycaemic control is crucial for preventing diabetes complications.
  • Nationwide data collection enables comprehensive analysis of trends in pediatric diabetes care.

Purpose of the Study:

  • To analyze trends in glycaemic control among children with type 1 diabetes (T1D) in Denmark from 1996 to 2006.
  • To identify factors associated with changes in haemoglobin A1c (HbA1c) levels over a decade.
  • To evaluate the impact of self-monitoring and hypoglycaemia on metabolic control in pediatric T1D patients.

Main Methods:

  • Utilized data from the Danish Registry of Childhood Diabetes, including 9291 HbA1c readings from 2705 children with T1D.
  • Employed generalized linear mixed models to assess glycaemic control trends and influencing variables.
  • Analyzed associations between HbA1c, self-monitoring frequency, insulin regimens, and hypoglycaemia events.

Main Results:

  • Mean HbA1c significantly decreased from 9.05% in 1997 to 8.20% in 2006, a reduction of 0.08% per year.
  • Increased frequency of self-monitoring of blood glucose was strongly associated with reduced HbA1c (p < 0.0001).
  • The percentage of children experiencing severe hypoglycaemia decreased, particularly in those with HbA1c between 6-8%.

Conclusions:

  • Metabolic control in Danish children with T1D has improved nationwide.
  • Increased self-monitoring of blood glucose and reduced hypoglycaemia are linked to better glycaemic control.
  • Newer insulin analogues or regimens did not show a significant association with the observed HbA1c improvements during this period.

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