Current state of type 1 diabetes treatment in the U.S.: updated data from the T1D Exchange clinic registry

Miller, Kellee M.; Foster, Nicole C.; Beck, Roy W.; Bergenstal, Richard M.; DuBose, Stephanie N.; DiMeglio, Linda A.; Maahs, David M.; Tamborlane, William V.

doi:10.2337/dc15-0078

Cited by 1,254Diabetes Management and ResearchDiabetes Management and EducationDiabetes and associated disorders

Current state of type 1 diabetes treatment in the U.S.: updated data from the T1D Exchange clinic registry

Miller, Kellee M., Foster, Nicole C., Beck, Roy W., Bergenstal, Richard M., DuBose, Stephanie N., DiMeglio, Linda A., Maahs, David M., Tamborlane, William V.·2015·Diabetes Care

DOI 10.2337/dc15-0078

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Abstract

To examine the overall state of metabolic control and current use of advanced diabetes technologies in the U.S., we report recent data collected on individuals with type 1 diabetes participating in the T1D Exchange clinic registry. Data from 16,061 participants updated between 1 September 2013 and 1 December 2014 were compared with registry enrollment data collected from 1 September 2010 to 1 August 2012. Mean hemoglobin A1c (HbA1c) was assessed by year of age from <4 to >75 years. The overall average HbA1c was 8.2% (66 mmol/mol) at enrollment and 8.4% (68 mmol/mol) at the most recent update. During childhood, mean HbA1c decreased from 8.3% (67 mmol/mol) in 2–4-year-olds to 8.1% (65 mmol/mol) at 7 years of age, followed by an increase to 9.2% (77 mmol/mol) in 19-year-olds. Subsequently, mean HbA1c values decline gradually until ∼30 years of age, plateauing at 7.5–7.8% (58–62 mmol/mol) beyond age 30 until a modest drop in HbA1c below 7.5% (58 mmol/mol) in those 65 years of age. Severe hypoglycemia (SH) and diabetic ketoacidosis (DKA) remain all too common complications of treatment, especially in older (SH) and younger patients (DKA). Insulin pump use increased slightly from enrollment (58–62%), and use of continuous glucose monitoring (CGM) did not change (7%). Although the T1D Exchange registry findings are not population based and could be biased, it is clear that there remains considerable room for improving outcomes of treatment of type 1 diabetes across all age-groups. Barriers to more effective use of current treatments need to be addressed and new therapies are needed to achieve optimal metabolic control in people with type 1 diabetes.

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Authors: Miller, K. M., Foster, N. C., Beck, R. W., Bergenstal, R. M., DuBose, S. N., DiMeglio, L. A., Maahs, D. M., & Tamborlane, W. V.
Affiliations: Jaeb Center for Health Research (US)
Park Nicollet Health Services (US)
Indiana University School of Medicine (US)
Barbara Davis Center for Childhood Diabetes, Aurora, CO
Yale University (US)
Corresponding author: Miller, Kellee M.
ORCID: Miller, Kellee M.
Foster, Nicole C.
Beck, Roy W.
Bergenstal, Richard M.
DuBose, Stephanie N.
DiMeglio, Linda A.
Maahs, David M.
Tamborlane, William V.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2015-05-12
Volume: 38
Issue: 6
Pages: 971-978
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/dc15-0078
OpenAlex: W2098570086
Cited by: 1,254
References: 25
Citations by year: 2026: 35 · 2025: 55 · 2024: 64 · 2023: 88 · 2022: 81 · 2021: 134 · 2020: 157 · 2019: 198 · 2018: 176 · 2017: 138 · 2016: 108 · 2015: 19
FWCI: 127.79
Type: journal article
Language: en
Open access: closed
Licence: www.diabetesjournals.org/site/license (vor, 203 d)
Locations: Diabetes Care (publishedVersion)
PubMed (publishedVersion)
Funders: Leona M. and Harry B. Helmsley Charitable Trust
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
Keywords: type 1 diabetes, glycemic control, HbA1c, severe hypoglycemia, diabetic ketoacidosis, insulin pump therapy, continuous glucose monitoring, diabetes technology, age trends
MeSH terms: Adolescent, Adult, Aged, Child, Child, Preschool, Diabetes Mellitus, Type 1, Health Services Needs and Demand, Glycated Hemoglobin, Humans, Insulin Infusion Systems, Male, Middle Aged, Registries, United States, Blood Glucose Self-Monitoring, Comorbidity, Diabetic Ketoacidosis, Young Adult

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Current state of type 1 diabetes treatment in the U.S.: updated data from the T1D Exchange clinic registry

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