Improved metabolic outcome in a Danish diabetic paediatric population aged 0-18 yr: results from a nationwide continuous Registration

Abstract

The objective of the present study was to describe the changes in glycaemic control based on data from the nationwide Danish Registry of Childhood Diabetes with valid haemoglobin A1c (HbA1c) readings centrally analysed between 1996 and 2006. The glycaemic control was assessed using generalized linear mixed models. Centre, age, diabetes duration, ethnicity, sex, self-monitoring of blood glucose, insulin regimens and hypoglycaemia was tested as explanatory variables. There were 9291 HbA1c recordings from 2705 children with T1D during the 10-yr period. The unadjusted mean HbA1c value in 1997 was 9.05% (95% CI +/- 0.82) and in 2006 was 8.20% (95% CI +/- 0.06). Mean HbA1c was significantly reduced over the years with a linear decrease of 0.08% per year (95% CI +/-0.011) (p < 0.0001). The decrease was unaffected by adjusting for number of injections, insulin/kg and use of insulin analogous. During the period, an increased frequency of self-monitored blood glucose was observed that was associated with a reduction in HbA1c (p < 0.0001). The percentage of children with severe hypoglycaemia decreased from 12.2 to 7.8% in those with HbA1c between 6 and 8%. Metabolic control in diabetic children has improved on a nationwide basis from the establishment of the national registry in 1996. The reduction in HbA1c was related to an increased number of self-monitoring of blood glucose values and a decrease in the number of hypoglycaemic events in those with the best metabolic control, whereas there were no association with the use of new analogous or insulin regimens.

Characterization of metabolic responders on CSII treatment amongst children and adolescents in Denmark from 2007 to 2013

“…In 2008 a follow-up study from the Danish Registry of Diabetes in Childhood and Adolescents demonstrated that the mean HbA 1c level decreased from 9.0% (95% CI AE 0.82) (75 mmol/mol) to 8.2% (95% CI AE 0.06) (66 mmol/mol) in the period from 1997 to 2006 [1]. The reason for this decrease is unknown.…”

The National Diabetes Register

“…The register collects clinical information on the registrees annually, and has a biobank associated with it, where DNA and serum samples (conditional on consent) are collected from new cases and first-degree relatives. It is considered 100% valid and is therefore a valuable source for epidemiological studies but also for clinical and biological studies [4] because of the biobank material available. As the register is clinically based there is no link to the NDR.…”

Management of diabetes mellitus in infants

“…130,133 Quality control To investigate outcomes of care in infant-onset diabetes mellitus, prospective data systems have been established by national networks. [134][135][136] Major differences in metabolic outcome have been demonstrated between international pediatric diabetes centers. 137 Including more than 38,000 children with diabetes aged 0-18 years, the prospective diabetes documentation initiative (DPV), which contains data from Germany and Austria, is one of the largest data documentation systems for childhood diabetes mellitus worldwide.…”