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Internal Medicine Journal - 2021 - Holmes‐Walker - Glycaemic outcomes in Australasian children and adults with type 1687.59 kB
Published VersionCC BY-NC-ND V4.0, Open Access
Journal article
Glycaemic outcomes in Australasian children and adults with type 1 diabetes: failure to meet targets across the age spectrum
Internal Medicine Journal, Vol.53(1), pp.61-67
2023
Abstract
Background
The goal of therapy in type 1 diabetes (T1D) is to achieve optimal glycaemic targets and reduce complications. Robust data representing glycaemic outcomes across the lifespan are lacking in Australasia.
Aims
To examine contemporary glycaemic outcomes and rate of use of diabetes technologies in Australasian people with T1D.
Methods
Cross-sectional analysis of de-identified data from 18 diabetes centres maintained in the Australasian Diabetes Data Network registry during 2019. Glycaemia was measured using glycated haemoglobin (HbA1c). The proportion of people with T1D achieving the international HbA1c target of <53 mmol/mol (7%) was calculated. Rates of continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) use were determined.
Results
A total of 7988 individuals with T1D with 30 575 visits were recorded in the registry. The median (interquartile range) age was 15.3 (10.0) years and diabetes duration was 5.7 (9.4) years with 49% on multiple daily injections (MDI) and 36% on CSII. The mean HbA1c for the whole cohort was 66 mmol/mol (8.2%). HbA1c increased with age, from 60 mmol/mol (7.6%) in children <10 years, increasing during adolescence and peaking at 73 mmol/mol (8.8%) in the 20–25 years age group. The HbA1c target of <53 mmol/mol (7%) was met in 18% of children and 13% of adults. HbA1c was lower on CSII as compared with those on MDI (P < 0.0001).
Conclusions
Only a minority of children and adults achieve the recommended glycaemic goals despite access to specialist care in major diabetes centres. There is a need to identify factors that improve glycaemic outcomes.
Details
- Title
- Glycaemic outcomes in Australasian children and adults with type 1 diabetes: failure to meet targets across the age spectrum
- Authors
- D Jane Holmes-Walker - Westmead HospitalMary B Abraham - Perth Children's Hospitalmelissa Chee - Juvenile Diabetes Research FoundationTimothy William Jones (Corresponding Author) - Perth Children's HospitalAustralasian Diabetes Data Network (ADDN) Study Group (Research Group)Steven James (Group Member) - University of the Sunshine Coast, Queensland, School of Health - Nursing
- Publication details
- Internal Medicine Journal, Vol.53(1), pp.61-67
- Publisher
- John Wiley & Sons, Inc.
- Date published
- 2023
- DOI
- 10.1111/imj.15426
- ISSN
- 1445-5994; 1444-0903
- Copyright note
- © 2021 The Authors. Internal Medicine Journal published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Physicians. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
- Grant note
- This research was supported by the Australian Type 1 Diabetes Clinical Research Network, led by the Juvenile Diabetes Research Foundation (JDRF) Australia with additional funding from the Australian Research Council (through a Special Research Initiative) and the Federal Department of Health and Ageing. M. B. Abraham is supported by Raine Clinical Research Fellowship, Western Australia.
- Organisation Unit
- School of Health - Nursing
- Language
- English
- Record Identifier
- 991103246302621
- Output Type
- Journal article
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- Domestic collaboration
- Web Of Science research areas
- Endocrinology & Metabolism
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