Metabolic control as reflectet by HbA1c in children, adolescents and young adults with type-1 diabetes mellitus: combined longitudinal analysis including 27,035 patients from 207 centers in Germany and Austria during the last decade

Gerstl, EM; Rabl, Wolfgang; Rosenbauer, Joachim; Gröbe, H; Hofer, Sabine E.; Krause, Ulf von; Holl, Reinhard W.

doi:10.1007/s00431-007-0586-9

Cited by 202 publications

(197 citation statements)

References 20 publications

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“…Missing and inconsistent data are reported back to the centers for correction. Data collection is approved by the ethics committee at Ulm University and by the IRBs at the participating centers (17,18 (19,20). SH was defined by both registries as a hypoglycemic event in which seizure or loss of consciousness occurred.…”

Section: Methodsmentioning

confidence: 99%

Obesity in Youth with Type 1 Diabetes in Germany, Austria, and the United States

DuBose

Hermann²,

Tamborlane

et al. 2015

The Journal of Pediatrics

152

129

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Section: Methodsmentioning

confidence: 99%

Obesity in Youth with Type 1 Diabetes in Germany, Austria, and the United States

DuBose

Hermann²,

Tamborlane

et al. 2015

The Journal of Pediatrics

152

129

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“…The DCCT trial indicated that among intensively treated adolescents, the average HbA 1c was 8.1%, and this changed little over time (26). A large cohort of 27,035 with type 1 diabetes in Austria in 2008 showed a mean HbA 1c of 8.0% between 12 and 16 years of age (27). Similarly, a study of patients on insulin pumps and continuous glucose monitoring showed mean HbA 1c levels between 8.0 and 8.2% among adolescents (28).…”

Section: Discussionmentioning

confidence: 98%

Exercise Training Improves but Does Not Normalize Left Ventricular Systolic and Diastolic Function in Adolescents With Type 1 Diabetes

et al. 2017

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OBJECTIVETo determine the impact of 20 weeks of exercise training in aerobic capacity on left ventricular function and glycemic control in adolescents with and without type 1 diabetes. RESEARCH DESIGN AND METHODSFifty-three adolescents with type 1 diabetes (aged 15.6 years) were divided into two groups: exercise training (n = 38) and nontraining (n = 15). Twenty-two healthy adolescents without diabetes (aged 16.7 years) were included and, with the 38 participants with type 1 diabetes, participated in a 20-week exercise-training intervention. Assessments included VO 2max and body composition. Left ventricular parameters were obtained at rest and during acute exercise using MRI. RESULTSExercise training improved aerobic capacity (10%) and stroke volume (6%) in both trained groups, but the increase in the group with type 1 diabetes remained lower than trained control subjects. Increased stroke volume in adolescents with type 1 diabetes resulted from greater left ventricular contractility (9% increase in ejection fraction and an 11% reduction in end-systolic volumes) and, to a lesser extent, improved left ventricular filling (6%), suggesting that impaired diastolic function can be affected by exercise training in adolescents with type 1 diabetes. Insulin use decreased by ∼10%, but no change in glycemic status was observed. CONCLUSIONSThese data demonstrate that in adolescents, the impairment in left ventricular function seen with type 1 diabetes can be improved, although not normalized, with regular intense physical activity. Importantly, diastolic dysfunction, a common mechanism causing heart failure in older subjects with diabetes, appears to be partially reversible in this age group.Regular physical activity has many potential health benefits, and there is strong evidence of its role in the primary and secondary prevention of chronic diseases such as cardiovascular disease and diabetes (1). In particular, exercise training improves exercise capacity and cardiac output by increasing left ventricular function (2-5). Training increases left ventricular stroke volume by enhancing intrinsic cardiac contractility

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“…In order to adjust for differences among centers, HbA 1c data were mathematically standardized to the Diabetes Control and Complication Trial reference range of 4.05-6.05% (20.77-42.62 mmol/mol) using the multiple of the mean method (21).…”

Section: Metabolic Controlmentioning

confidence: 99%

Does β-Cell Autoimmunity Play a Role in Cystic Fibrosis–Related Diabetes? Analysis Based on the German/Austrian Diabetes Patienten Verlaufsdokumentation Registry

Konrad

Kapellen

Lilienthal³

et al. 2016

Diabetes Care

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OBJECTIVEResearch on b-cell autoimmunity in cystic fibrosis (CF)-related diabetes (CFRD) is still rare. We aimed to analyze the frequency of b-cell autoimmunity and the influence on age at diabetes onset, insulin requirement, type of insulin therapy, and hypoglycemic or ketoacidotic events in patients with CFRD compared with antibody-negative patients with CFRD in the Diabetes Patienten Verlaufsdokumentation (DPV) registry. RESEARCH DESIGN AND METHODSWe analyzed data of 837 patients with CFRD in the German/Austrian DPV database by multivariable mixed-regression modeling. RESULTSIn our cohort, 8.5% of patients with CFRD (n = 72) were found to be b-cell antibody positive. There was a female preponderance in this patient group: 65.3 vs. 57.6%. Diabetes onset (median [interquartile range]) was earlier (14.00 [10.15-15.90] vs. 16.10 [13.50-21.20] years; P < 0.005), and insulin dose/kg body weight was higher (0.95 [0.61-1.15] vs. 0.67 [0.33-1.04] IU/kg; P < 0.05). There were also differences in the type of insulin treatment. Insulin pump therapy was used significantly more often in patients with CFRD with b-cell autoimmunity (18.2 vs. 6.4%; P < 0.05). The differences for multiple daily injections (ICT) and conventional therapy (CT) were not significant (ICT: 67.7 vs. 79.0%; CT: 15.2 vs. 14.6). Oral antidiabetic agents were rarely used in both groups. Rate of severe hypoglycemia with coma and rate of ketoacidosis were higher in antibody-positive patients (hypoglycemia with coma: 8.0 vs. 1.4, P < 0.05; ketoacidosis: 9.3 vs. 0.9, P < 0.05). CONCLUSIONSPresence of b-cell autoantibodies in our cohort of patients with CFRD (8.5%) appeared to be greater than in the general population and was associated with female sex, earlier onset of diabetes, and higher insulin requirement. Insulin pump therapy was used significantly more often in patients with b-cell antibodies. Severe hypoglycemia and ketoacidosis were significantly more frequent in CFRD with b-cell autoimmunity compared with b-cell antibody-negative patients with CFRD.

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Metabolic control as reflectet by HbA1c in children, adolescents and young adults with type-1 diabetes mellitus: combined longitudinal analysis including 27,035 patients from 207 centers in Germany and Austria during the last decade

Cited by 202 publications

References 20 publications

Obesity in Youth with Type 1 Diabetes in Germany, Austria, and the United States

Obesity in Youth with Type 1 Diabetes in Germany, Austria, and the United States

Exercise Training Improves but Does Not Normalize Left Ventricular Systolic and Diastolic Function in Adolescents With Type 1 Diabetes

Does β-Cell Autoimmunity Play a Role in Cystic Fibrosis–Related Diabetes? Analysis Based on the German/Austrian Diabetes Patienten Verlaufsdokumentation Registry

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