| Improved Metabolic Control in Children and Adolescents With Type 1 Diabetes: A trend analysis using prospective multicenter data from Germany and Austria. | |
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MedLine Citation:
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PMID: 22074726 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVETo investigate the temporal trend of metabolic control and potential predictors in German and Austrian children and adolescents with type 1 diabetes.RESEARCH DESIGN AND METHODSThis study is based on a large, multicenter database for prospective longitudinal documentation of diabetes care in Germany and Austria. Data from 30,708 patients documented in 305 diabetes centers between 1995 and 2009 were analyzed. Generalized linear mixed regression models were used to adjust trend analysis for relevant confounders.RESULTSUnadjusted mean HbA(1c) decreased from 8.7 ± 1.8% in 1995 to 8.1 ± 1.5% in 2009. In multiple regression analysis, treatment year, age, sex, diabetes duration, migration background, BMI-SDS, and daily insulin dose were significant predictors of metabolic control (P < 0.001). After multiple adjustment, mean HbA(1c) decreased significantly by 0.038% per year (95% CI 0.032-0.043%), average odds ratio (OR) per year for HbA(1c) >7.5% (>9.0%) was 0.969 (95% CI 0.961-0.977) (0.948, 95% CI 0.941-0.956). Intensified insulin regimen was associated with lower frequency of poor metabolic control (HbA(1c) >9%; P = 0.005) but not with average HbA(1c) (P = 0.797). Rate of severe hypoglycemia and hypoglycemic coma decreased significantly (relative risk per year [RR] 0.948, 95% CI 0.918-0.979; RR 0.917, 95% CI 0.885-0.950) over the study period. Diabetic ketoacidosis rate showed no significant variation over time.CONCLUSIONSThis study showed a significant improvement in metabolic control in children and adolescents with type 1 diabetes during the past decade and a simultaneous decrease in hypoglycemic events. The improvement was not completely explained by changes in the mode of insulin treatment. Other factors like improved patient education may have accounted for the observed trend. |
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Authors:
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Joachim Rosenbauer; Axel Dost; Beate Karges; Andreas Hungele; Anna Stahl; Christina Bächle; Eva Maria Gerstl; Christian Kastendieck; Sabine E Hofer; Reinhard W Holl; |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-10 |
Journal Detail:
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Title: Diabetes care Volume: - ISSN: 1935-5548 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-14 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7805975 Medline TA: Diabetes Care Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center at University of Düsseldorf, Düsseldorf, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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