New to MyHealth?
Manage Your Care From Anywhere.
Access your health information from any device with MyHealth. You can message your clinic, view lab results, schedule an appointment, and pay your bill.
ALREADY HAVE AN ACCESS CODE?
DON'T HAVE AN ACCESS CODE?
NEED MORE DETAILS?
MyHealth for Mobile
Temporal changes in hemoglobin A1c and diabetes technology use in DPV, NPDA and T1DX pediatric cohorts from 2010 to 2018.
Temporal changes in hemoglobin A1c and diabetes technology use in DPV, NPDA and T1DX pediatric cohorts from 2010 to 2018. Diabetes technology & therapeutics Lal, R. A., Robinson, H., Lanzinger, S., Miller, K., Perez, S. P., Kovacic, R., Calhoun, P., Campbell, F., Naeke, A., Maahs, D. M., Holl, R. W., Warner, J. 2022Abstract
Objective The German/Austrian Diabetes Patient Follow-up Registry (DPV), England/Wales National Pediatric Diabetes Audit (NPDA), and Type 1 Diabetes Exchange (T1DX) in the U.S. investigated changes in hemoglobin A1c (HbA1c) and diabetes technology use from 2010-2018. Methods Registry/audit data from 2010-2018 were analyzed in annual cohorts using linear regression for those <18 years of age with type 1 diabetes diagnosed at age >6 months. Time trends in HbA1c, pump, and CGM use were studied using repeated measurements linear and logistic regression models with an autoregressive covariance structure and with year and data source as independent variables. Results 1,172,980 visits among 114,264 (54,119 DPV, 43,550 NPDA, 16,595 T1DX) patients were identified. HbA1c remained clinically stable in DPV (7.7%[61mmol/mol] to 7.6%[60mmol/mol]), decreased in the NPDA (8.7%[72mmol/mol] to 7.9%[63mmol/mol]), and increased in T1DX (8.0%[64mmol/mol] to 8.5%[69mmol/mol] from 2010 to 2018). In all registries/audits, insulin pump and CGM use increased over time with greatest pump use in T1DX and lowest uptake reported in NPDA. Conclusions These data reveal three different longitudinal patterns of change in registry/audit HbA1c from 2010-2018. Diabetes technology use increased throughout, at different rates. Quality improvement (QI) programs in DPV have been ongoing for 25 years, began in NPDA 2009, and T1DX in 2016. We speculate that in England/Wales development of networks, peer-review, and implementation of QI measures contributed to reductions in population HbA1c. Many of these interventions had been implemented in DPV prior to 2010. Further efforts to understand this improvement, including the role of QI, and continued success within standardized documentation and benchmarking could inform T1DX programs to reduce HbA1c.
View details for DOI 10.1089/dia.2022.0095
View details for PubMedID 35856740