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Tracking of metabolic control from childhood to young adulthood in type 1 diabetes

OBJECTIVE: This prospective longitudinal survey was designed to follow patients with diabetes from disease onset in childhood over an extended period of time including puberty until young adulthood with respect to metabolic control. - STUDY DESIGN: An electronic diabetes patient documentation system...

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Main Authors: Hofer, Sabine (Author) , Raile, Klemens (Author) , Fröhlich-Reiterer, Elke (Author) , Kapellen, Thomas (Author) , Dost, Axel (Author) , Rosenbauer, Joachim (Author) , Grulich-Henn, Jürgen (Author) , Holl, Reinhard W. (Author)
Format: Article (Journal)
Language:English
Published: 20 August 2014
In: The journal of pediatrics
Year: 2014, Volume: 165, Issue: 5, Pages: 956-961.e2
ISSN:1097-6833
DOI:10.1016/j.jpeds.2014.07.001
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jpeds.2014.07.001
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Author Notes:Sabine E. Hofer, Klemens Raile, Elke Fröhlich-Reiterer, Thomas Kapellen, Axel Dost, Joachim Rosenbauer, Jürgen Grulich-Henn, and Reinhard W. Holl, on behalf of theAustrian/German Diabetes Patienten Verlaufsdokumentation (DPV Initiative) and the German Competence Network for Diabetes Mellitus
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Summary:OBJECTIVE: This prospective longitudinal survey was designed to follow patients with diabetes from disease onset in childhood over an extended period of time including puberty until young adulthood with respect to metabolic control. - STUDY DESIGN: An electronic diabetes patient documentation system used in diabetes centers in Austria and Germany was utilized for standardized data collection. Complete documentation of metabolic control for prepuberty (≤ 13 years), puberty (14-19 years), and adulthood (≥ 20 years) was available in 1146 patients. - RESULTS: Median age at diabetes manifestation was 7.2 (IQR 4.7-9.4) years; 49% were male. In the prepubertal stage, median glycated hemoglobin A1c (HbA1c) was 7.5 (IQR 6.8-8.3), during puberty 8.0 (IQR 7.3-8.9), and after puberty 7.8 (IQR 7.1-9.0). A significant intra-individual correlation was found for prepuberty to puberty HbA1c levels (R = 0.55, P < .001), puberty to adulthood (R = 0.59, P < .001), as well as prepuberty to adulthood (R = 0.30, P < .001). When patients were divided into tertiles of prepubertal HbA1c, HbA1c increased in all 3 groups over time, however, significant group differences tracked into adulthood (P < .001 at all stages). A regression model identified pre-pubertal HbA1c as a significant and relevant predictor of metabolic control in young adulthood adjusted for confounders (P < .001). - CONCLUSIONS: This survey provides evidence for long-term tracking of metabolic control from childhood until adulthood, suggesting an early focus on metabolic control.
Item Description:Gesehen am 21.12.2020
Physical Description:Online Resource
ISSN:1097-6833
DOI:10.1016/j.jpeds.2014.07.001

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