Glycaemic control of Type1 diabetes in clinical practice early in the 21st century: an international comparison
Glycaemic control of Type1 diabetes in clinical practice early in the 21st century: an international comparison
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DOI：
10.1111/dme.12676
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发表时间：
2015-08-01
影响因子：
3.5
通讯作者：
Miller, K. M.
中科院分区：
文献类型：
--
作者：
McKnight, J. A.;Wild, S. H.;Miller, K. M.
众所周知，改善 1 型糖尿病患者的血糖控制可以减少并发症。我们的目的是使用在地区或国家登记处收集的数据来比较 1 型糖尿病患者的血糖控制情况。 方法 获得来自以下国家（或地区）的 1 型糖尿病儿童和/或成人的数据：西澳大利亚、奥地利、丹麦、英国、香槟-阿登（法国）、德国、伊庇鲁斯、塞萨利和塞萨洛尼基（希腊）、戈尔韦 （爱尔兰）、意大利几个地区、拉脱维亚、鹿特丹（荷兰）、奥塔哥（新西兰）、挪威、北爱尔兰、苏格兰、瑞典、沃伦（乌克兰）、美国和威尔士）来自人口或诊所登记处。具有可用数据的样本量从 355 到 173880 不等。按年龄和性别比较 HbA(1c) = 9.0%) 的比例。结果 可获得 324501 人的数据。 HbA(1c) 58mmol/mol 的比例（= 25 岁）。血糖控制方面的性别差异很小。使用胰岛素泵的人数在 12 个可用数据来源之间存在差异。结论 这些结果表明，数据来源之间 1 型糖尿病患者的血糖控制存在显着差异，所有人群，尤其是年轻人，都有改善的空间。有什么新鲜事？我们提出 来自 19 个不同国家/地区的登记处的 HbA(1c) 数据描述了所有年龄组的 324501 名 1 型糖尿病患者的控制情况。这些数据是现有糖尿病护理的最佳代表，因此描述了现有技术的水平。我们清楚地表明，1 型糖尿病的控制并不像指南中建议的那么好，但某些医疗保健系统似乎比其他系统能更好地控制。这些数据对糖尿病服务提出了挑战。领导者 糖尿病单位/服务可以将他们的本地数据与我们的数据进行比较并鼓励改进。
Aims Improving glycaemic control in people with Type1 diabetes is known to reduce complications. Our aim was to compare glycaemic control among people with Type1 diabetes using data gathered in regional or national registries.Methods Data were obtained for children and/or adults with Type1 diabetes from the following countries (or regions): Western Australia, Austria, Denmark, England, Champagne-Ardenne (France), Germany, Epirus, Thessaly and Thessaloniki (Greece), Galway (Ireland), several Italian regions, Latvia, Rotterdam (The Netherlands), Otago (New Zealand), Norway, Northern Ireland, Scotland, Sweden, Volyn (Ukraine), USA and Wales) from population or clinic-based registries. The sample size with available data varied from 355 to 173880. Proportions with HbA(1c) = 9.0%) were compared by age and sex.Results Data were available for 324501 people. The proportions with HbA(1c) 58mmol/mol (= 25 years. Sex differences in glycaemic control were small. Proportions of people using insulin pumps varied between the 12 sources with data available.Conclusion These results suggest that there are substantial variations in glycaemic control among people with Type1 diabetes between the data sources and that there is room for improvement in all populations, especially in young adults.What's new?We present HbA(1c) data from registries in 19 different countries describing control in 324501 people with Type1 diabetes, across all age groups. These data are the best representation of diabetes care available and therefore describe the state of the art'. We show clearly that Type1 diabetes control is not as good as suggested in guidelines, but that some healthcare systems appear to result in better control than others. These data present a challenge to diabetes services. Leaders in diabetes units/service can compare their local data to our data and encourage improvement.