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Type 1 diabetes during adolescence: International comparison between Germany, Austria, and Sweden.
Division of Nursing Science, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Division of Paediatrics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.
Department of Pediatrics, Medical University of Graz, Graz, Austria.
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2018 (English)In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 19, no 3, p. 506-511Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: By using pediatric diabetes quality registries in Austria, Germany, and Sweden treatment of type 1 diabetes and the outcome of care during the vulnerable adolescence period were compared.

METHODS: Data in DPV, broadly used in Austria and Germany, and Swediabkids used in Sweden, from clinical visits in the year 2013 on 14 383 patients aged 11 to 16 years regarding hemoglobin A1c (HbA1c), insulin regimen, body mass index (BMI)-SD score (SDS), blood pressure, hypoglycemia, ketoacidosis, and smoking habits were analyzed.

RESULTS: Patients in Sweden had fewer clinical visits per year (P < .05), lower insulin dose per kg (P < .001), and lower proportion of fast acting insulin compared with Germany and Austria (P < .001). The proportion of pump users was higher in Sweden (P < .001). Patients in Sweden had lower mean HbA1c levels (Austria: 64 mmol/mol, Germany: 63 mmol/mol, and Sweden: 61 mmol/mol [8.0%, 7.9%, and 7.7%, respectively]; P < .001). The frequency of severe hypoglycemia was higher in Sweden while it was lower for ketoacidosis (3.3% and 1.1%, respectively) than in Austria (1.1% and 5.3%) and Germany (2.0% and 4.4%) (P < .001). Girls in all 3 countries had higher HbA1c and BMI-SDS than boys.

CONCLUSIONS: Sharing data between diabetes registries and nations enables us to better understand differences in diabetes outcome between countries. In this particular comparison, pediatric patients with diabetes in Sweden were more often treated with insulin pump, had lower HbA1c levels and a higher rate of severe hypoglycemia. Patients in Austria and Germany used rapid acting insulin analogs more often and had a lower rate of ketoacidosis.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018. Vol. 19, no 3, p. 506-511
Keyword [en]
adolescents, metabolic control, quality of care, quality registry, type 1 diabetes
National Category
Endocrinology and Diabetes Pediatrics
Identifiers
URN: urn:nbn:se:hj:diva-39387DOI: 10.1111/pedi.12591ISI: 000430921600025PubMedID: 28940551Scopus ID: 2-s2.0-85045884711Local ID: HHJIMPROVEISOAI: oai:DiVA.org:hj-39387DiVA, id: diva2:1205022
Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2018-05-09Bibliographically approved

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