A high mean-HbA1c value 3-15 months after diagnosis of type 1 diabetes in childhood is related to metabolic control, macroalbuminuria, and retinopathy in early adulthood-a pilot study using two nation-wide population based quality registries: Metabolic control in adults and children
Open accessAbstract
BACKGROUND: Intensive treatment of patients with type 1 diabetes delays the onset of long-term complications. OBJECTIVES: On the basis of the information from two nation-wide quality registers, we investigated to which extent HbA1c values 3-15 months after diagnosis in childhood are related to metabolic control, albuminuria, and retinopathy in early adulthood. METHODS: In Sweden, physicians register all children and adolescents with type 1 diabetes mellitus in the Swedish Pediatric Quality Registry. After 18 yr of age, people with diabetes are followed by the Swedish National Diabetes Register. We identified 1543 children and adolescents with a mean age of 13.9 yr at diagnosis and a mean duration of type 1 diabetes mellitus of 7.1 yr. RESULTS: Children and adolescents with poor metabolic control (mean HbA1c ≥ 70 mmol/mol (8.6 %)) adjacent to diagnosis had a significantly higher mean HbA1c value years later as adults than did patients with a good metabolic control [<50 mmol/mol (6.7%) (p < 0.001)]. The patients in the high group were also less physically active and smoked more as adults. The proportion of females was higher in the poor metabolic group. Patients with a high mean HbA1c 3-15 months after diagnosis had significantly more often macroalbuminuria and retinopathy in early adulthood. CONCLUSIONS: Metabolic control adjacent to the diagnosis of type 1 diabetes in childhood or adolescence can predict metabolic control in early adulthood. It is therefore very important that pediatric diabetes teams identify key factors for successful early metabolic control. Actively using quality registries may be one such factor.
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The Swedish Childhood Diabetes Register has recorded new cases of type 1 diabetes in children under 15 years with 96-99% national coverage since 1977.
“Since 1 July 1977, the SCDR has recorded new incidents of type 1 diabetes in children below the age of 15 years with high level of national coverage (96–99%) (13).”
From Risks of psychiatric disorders and suicide attempts in children and adolescents with type 1 diabetes: a population-based cohort study (2015) · cites this paper as [13]
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- Authors
- Samuelsson, U., Steineck, I., & Gubbjornsdottir, S.
- Affiliations
- Linköping University Hospital (SE)
- Regionshospitalet Herning (DK)
- Sahlgrenska University Hospital (SE)
- Corresponding author
- Samuelsson, Ulf
- Venue
- Pediatric Diabetes
- Publisher
- Hindawi Limited
- Published
- 2013-09-30
- Volume
- 15
- Issue
- 3
- Pages
- 229-235
- ISSN
- 1399-543X (ISSN-L)
- OpenAlex
- W1529759021
- Cited by
- 101
- References
- 23
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 10 · 2023: 9 · 2022: 6 · 2021: 11 · 2020: 9 · 2019: 4 · 2018: 7 · 2017: 6 · 2016: 9 · 2015: 10 · 2014: 3
- FWCI
- 5.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Pediatric Diabetes (publishedVersion)
- PubMed (publishedVersion)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- Funders
- Sveriges Kommuner och Landsting
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 1 diabetes, childhood-onset diabetes, glycemic control, HbA1c, macroalbuminuria, diabetic nephropathy, diabetic retinopathy, early adulthood, diabetes complications, physical activity, smoking, sex differences, quality register
- MeSH terms
- Adolescent, Adult, Albuminuria, Child, Child, Preschool, Diabetes Mellitus, Type 1, Diabetic Nephropathies, Diabetic Retinopathy, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Hyperglycemia, Health Knowledge, Attitudes, Practice, Male, Pilot Projects, Registries, Risk Factors, Severity of Illness Index, Sex Factors, Sweden, Cohort Studies, Disease Progression, Young Adult
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