Five years of improving diabetes control in Czech children after the establishment of the population‐based childhood diabetes register ČENDA

Šumnı́k, Zdenĕk; Venhácová, J; Škvor, Jaroslav; Pomahačová, Renata; Konečná, Petra; Neumann, David; Vosáhlo, Jan; Strnadel, Jiří; Čížek, Jindřich; Obermannová, Barbora; Petruželková, Lenka; Průhová, Štěpánka; Pavlı́ková, Markéta; Cinek, Ondřej

doi:10.1111/pedi.12929

Cited by 18 publications

(18 citation statements)

References 29 publications

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“…Data sources Data sources consisted of population-based registries (Australia, New Zealand [Auckland], Austria, Czechia, Denmark, Germany, Luxembourg, Norway, Slovenia, Sweden, Wales), nationwide clinical records (Italy) and a national multicentre study (USA [SEARCH]) with a completeness of coverage of at least 90% during the study period, as previously described [21,25,[27][28][29][30][31][32][33]. All data owners gave the permission for publication.…”

Section: Data Collectionmentioning

confidence: 99%

Temporal trends in diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes between 2006 and 2016: results from 13 countries in three continents

et al. 2020

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Aims/hypothesis The aim of this work was to evaluate geographical variability and trends in the prevalence of diabetic ketoacidosis (DKA), between 2006 and 2016, at the diagnosis of childhood-onset type 1 diabetes in 13 countries over three continents. Methods An international retrospective study on DKA at diagnosis of diabetes was conducted. Data on age, sex, date of diabetes diagnosis, ethnic minority status and presence of DKA at diabetes onset were obtained from Australia,

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Section: Data Collectionmentioning

confidence: 99%

Temporal trends in diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes between 2006 and 2016: results from 13 countries in three continents

et al. 2020

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“…In contrast, the international SWEET registry reports the mean HbA1c in individual clinics in many developing countries such as India, Nepal, and Mexico are in the 8-9.5% range, suggesting that even in resource-poor situations, better glucose control than the USA can be achieved (13). Therefore, other countries have effectively implemented the DCCT message of intensive glucose control, leaving the USA as an outlier in achieved pediatric HbA1c (14)(15)(16). In fact, pediatric HbA1c in the T1DX was higher in the 2017 data than in 2010-2012 data (17).…”

Section: Introductionmentioning

confidence: 99%

Improving Clinical Outcomes in Newly Diagnosed Pediatric Type 1 Diabetes: Teamwork, Targets, Technology, and Tight Control—The 4T Study

et al. 2020

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Many youth with type 1 diabetes (T1D) do not achieve hemoglobin A1c (HbA1c) targets. The mean HbA1c of youth in the USA is higher than much of the developed world. Mean HbA1c in other nations has been successfully modified following benchmarking and quality improvement methods. In this review, we describe the novel 4T approachteamwork, targets, technology, and tight control-to diabetes management in youth with new-onset T1D. In this program, the diabetes care team (physicians, nurse practitioners, certified diabetes educators, dieticians, social workers, psychologists, and exercise physiologists) work closely to deliver diabetes education from diagnosis. Part of the education curriculum involves early integration of technology, specifically continuous glucose monitoring (CGM), and developing a curriculum around using the CGM to maintain tight control and optimize quality of life.

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“…A general decrease in HbA1C over time was noted between 2016 and 2019 (from 63.0 to 57.3 mmol/mol, i.e., −1.9 mmol/mol/year, Table 1); this decrease was more rapid than that observed in the ČENDA registry between 2013 and 2016 (from 66.3 to 63.0 mmol/mol, i.e., −1.1 mmol/mol/year) 9 . Figure 6 documents that the pace of this decrease in 2017–2019 (i.e., after general reimbursement for rtCGM) was associated with the usage of CGM (only patients on rtCGM were included into this longitudinal analysis due to small numbers of patients on isCGM before 2019).…”

Section: Resultsmentioning

confidence: 84%

“…The national pediatric diabetes web‐based register ČENDA (the acronym for the Czech words for Czech National Pediatric Diabetes Database) has been described elsewhere in detail 9 . In short, this system collects anonymized data on every patient aged 0–18.99 years with any type of diabetes who is attending one of the participating pediatric diabetes outpatient clinics.…”

Section: Methodsmentioning

confidence: 99%

“…The Czech National Childhood Diabetes Register (ČENDA) is a nationwide pediatric diabetes treatment register established in 2013 that stores the process and outcome data of children and adolescents with diabetes and allows anonymous comparisons among over 50 diabetes clinics in the country. In our recent paper, we reported a significant decrease in HbA1c between 2013 and 2017 across all age categories that was not accompanied by an increase in the risk of acute diabetic complications 9 . The proportion of children treated with insulin pump (CSII) did not change over the 5‐year follow‐up period, indicating that this improvement was independent of CSII prescription.…”

Section: Introductionmentioning

confidence: 95%

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Use of continuous glucose monitoring and its association with type 1 diabetes control in children over the first 3 years of reimbursement approval: Population data from the ČENDA registry

et al. 2021

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Objective Increased access to modern technologies is not always accompanied by a decrease in HbA1c. The aim of this study was to identify changes in the proportion of continuous glucose monitoring (CGM) users since 2017, when general reimbursement for CGM became effective in Czechia, and to test whether HbA1c is associated with the percentage of time spent on CGM. Research design and methods All T1D children in the Czech national ČENDA registry (3197 children) were categorized according to their time spent on CGM and associations with age, sex, center size, and HbA1c were tested with calendar year as a stratification factor. Results The proportion of children with any CGM use increased from 37.9% in 2017 to 50.3% in 2018 and 74.8% in 2019. Of the CGM users, 16%, 28%, and 41% of the children spent >70% of their time on CGM over the 3 years of the study period, with an overrepresentation of children in the <10 years age group versus the older age groups (p < 0.001). The proportion of CGM users differed among centers and was positively associated with a large center size (>100 patients) (p < 0.001). HbA1c was negatively associated with the time spent on CGM (p < 0.001). Conclusions A rapid increase in CGM use was reported over the 3 years after general reimbursement. HbA1c was associated with time spent on CGM, a continuing decrease was observed in the >70% category. Reimbursement for CGM likely contributes to the improvement of T1D control at the population level.

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Five years of improving diabetes control in Czech children after the establishment of the population‐based childhood diabetes register ČENDA

Cited by 18 publications

References 29 publications

Temporal trends in diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes between 2006 and 2016: results from 13 countries in three continents

Temporal trends in diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes between 2006 and 2016: results from 13 countries in three continents

Improving Clinical Outcomes in Newly Diagnosed Pediatric Type 1 Diabetes: Teamwork, Targets, Technology, and Tight Control—The 4T Study

Use of continuous glucose monitoring and its association with type 1 diabetes control in children over the first 3 years of reimbursement approval: Population data from the ČENDA registry

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