Suboptimal glycemic control in adolescents and young adults with type 1 diabetes from 2011 to 2020 across Australia and New Zealand: Data from the Australasian Diabetes Data Network registry

ADDN study group; Steven James; Lin Perry; Julia Lowe; Margaret Harris; Maria E. Craig; Michelle Jack

doi:10.1111/pedi.13364

Suboptimal glycemic control in adolescents and young adults with type 1 diabetes from 2011 to 2020 across Australia and New Zealand: Data from the Australasian Diabetes Data Network registry

ADDN study group, Steven James^*, Lin Perry, Julia Lowe, Margaret Harris, Maria E. Craig, Michelle Jack

^*Corresponding author for this work

Research output: Contribution to journal › Article › Research › peer-review

11 Citations (Scopus)

Abstract

Background:

Competing challenges in adolescence and young adulthood can distract from optimal type 1 diabetes (T1D) self-management, and increase risks of premature morbidity and mortality. There are limited data mapping the glycemic control of people with T1D in this age group, across Australasia.

Research Design and Methods:

Clinical data were extracted from the Australasian Diabetes Data Network, a prospective clinical diabetes registry. Inclusion criteria were individuals with T1D aged 16–25 years at their last recorded T1D healthcare visit (from 1st January 2011 to 31st December 2020), with T1D duration of at least 1 year. Data were stratified by two last recorded T1D healthcare visit ranges, while generalized estimated equation (GEE) modeling was used to examine factors associated with HbA1c across visits during the 10 year period.

Results:

Data from 6329 young people (52.6% male) attending 24 diabetes centers across Australasia were included. At the last visit within the most recent 5 years, mean ± SD age was 18.5 ± 2.3 years, T1D duration was 8.8 ± 4.7 years and HbA1c was 8.8 ± 1.8% (72.2 ± 19.9 mmol/mol); only 12.3% had an HbA1c below the international target of <7.0% (53 mmol/mol). Across all T1D healthcare visits, in GEE modeling, higher HbA1c was associated with female sex (B = 0.20; 95% CI 0.12 to 0.29, p < 0.001), longer T1D duration (B = 0.04, 0.03 to 0.05, p < 0.001). Lower HbA1c was associated with attendance at a pediatric T1D healthcare setting (B = −0.33, −0.45 to −0.21, p < 0.001) and use of CSII versus BD/MDI therapy (B = −0.49, −0.59 to 0.40, p < 0.001).

Conclusions:

This Australasian study demonstrates widespread and persistent sub-optimal glycemic control in young people with T1D, highlighting the urgent need to better understand how healthcare services can support improved glycemic control in this population.

Original language	English
Pages (from-to)	736-741
Number of pages	6
Journal	Pediatric Diabetes
Volume	23
Issue number	6
DOIs	https://doi.org/10.1111/pedi.13364
Publication status	Published - Sept 2022
Externally published	Yes

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/pedi.13364

Cite this

@article{822bbc21dfec48da90623bd6813d3fc0,

title = "Suboptimal glycemic control in adolescents and young adults with type 1 diabetes from 2011 to 2020 across Australia and New Zealand: Data from the Australasian Diabetes Data Network registry",

abstract = "Background: Competing challenges in adolescence and young adulthood can distract from optimal type 1 diabetes (T1D) self-management, and increase risks of premature morbidity and mortality. There are limited data mapping the glycemic control of people with T1D in this age group, across Australasia. Research Design and Methods: Clinical data were extracted from the Australasian Diabetes Data Network, a prospective clinical diabetes registry. Inclusion criteria were individuals with T1D aged 16–25 years at their last recorded T1D healthcare visit (from 1st January 2011 to 31st December 2020), with T1D duration of at least 1 year. Data were stratified by two last recorded T1D healthcare visit ranges, while generalized estimated equation (GEE) modeling was used to examine factors associated with HbA1c across visits during the 10 year period. Results: Data from 6329 young people (52.6% male) attending 24 diabetes centers across Australasia were included. At the last visit within the most recent 5 years, mean ± SD age was 18.5 ± 2.3 years, T1D duration was 8.8 ± 4.7 years and HbA1c was 8.8 ± 1.8% (72.2 ± 19.9 mmol/mol); only 12.3% had an HbA1c below the international target of <7.0% (53 mmol/mol). Across all T1D healthcare visits, in GEE modeling, higher HbA1c was associated with female sex (B = 0.20; 95% CI 0.12 to 0.29, p < 0.001), longer T1D duration (B = 0.04, 0.03 to 0.05, p < 0.001). Lower HbA1c was associated with attendance at a pediatric T1D healthcare setting (B = −0.33, −0.45 to −0.21, p < 0.001) and use of CSII versus BD/MDI therapy (B = −0.49, −0.59 to 0.40, p < 0.001). Conclusions: This Australasian study demonstrates widespread and persistent sub-optimal glycemic control in young people with T1D, highlighting the urgent need to better understand how healthcare services can support improved glycemic control in this population.",

author = "{ADDN study group} and Steven James and Lin Perry and Julia Lowe and Margaret Harris and Craig, {Maria E.} and Kym Anderson and Sof Andrikopoulos and Geoff Ambler and Helen Barrett and Jenny Batch and Philip Bergman and Fergus Cameron and Peter Colman and Louise Conwell and Andrew Cotterill and Chris Cooper and Jennifer Couper and Elizabeth Davis and {de Bock}, Martin and Kim Donaghue and Jan Fairchild and Gerry Fegan and Spiros Fourlanos and Sarah Glastras and Leonie Gray and Shane Hamblin and Paul Hofman and Holmes-Walker, {Dianne Jane} and Neville Howard and Michelle Jack and Craig Jefferies and Tim Jones and Stephanie Johnson and Jeff Kao and King, {Bruce R.} and Antony Lafferty and Michelle Martin and Robert McCrossin and Mark Pascoe and Ryan Paul and Alexia Pe{\~n}a and Darrell Price and Christine Rodda and David Simmons and Richard Sinnott and Alan Sive and Carmel Smart and Monique Stone and Steve Stranks and Elaine Tham and Charles Verge and Jerry Wales and Glenn Ward and Ben Wheeler and Judy Williams and Helen Woodhead and Nick Woolfield and Anthony Zimmermann",

note = "Publisher Copyright: {\textcopyright} 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",

year = "2022",

month = sep,

doi = "10.1111/pedi.13364",

language = "English",

volume = "23",

pages = "736--741",

journal = "Pediatric Diabetes",

issn = "1399-543X",

publisher = "Blackwell Munksgaard",

number = "6",

}

Suboptimal glycemic control in adolescents and young adults with type 1 diabetes from 2011 to 2020 across Australia and New Zealand: Data from the Australasian Diabetes Data Network registry. / ADDN study group; James, Steven; Perry, Lin et al.
In: Pediatric Diabetes, Vol. 23, No. 6, 09.2022, p. 736-741.

Research output: Contribution to journal › Article › Research › peer-review

TY - JOUR

T1 - Suboptimal glycemic control in adolescents and young adults with type 1 diabetes from 2011 to 2020 across Australia and New Zealand: Data from the Australasian Diabetes Data Network registry

AU - ADDN study group

AU - James, Steven

AU - Perry, Lin

AU - Lowe, Julia

AU - Harris, Margaret

AU - Craig, Maria E.

AU - Anderson, Kym

AU - Andrikopoulos, Sof

AU - Ambler, Geoff

AU - Barrett, Helen

AU - Batch, Jenny

AU - Bergman, Philip

AU - Cameron, Fergus

AU - Colman, Peter

AU - Conwell, Louise

AU - Cotterill, Andrew

AU - Cooper, Chris

AU - Couper, Jennifer

AU - Davis, Elizabeth

AU - de Bock, Martin

AU - Donaghue, Kim

AU - Fairchild, Jan

AU - Fegan, Gerry

AU - Fourlanos, Spiros

AU - Glastras, Sarah

AU - Gray, Leonie

AU - Hamblin, Shane

AU - Hofman, Paul

AU - Holmes-Walker, Dianne Jane

AU - Howard, Neville

AU - Jack, Michelle

AU - Jefferies, Craig

AU - Jones, Tim

AU - Johnson, Stephanie

AU - Kao, Jeff

AU - King, Bruce R.

AU - Lafferty, Antony

AU - Martin, Michelle

AU - McCrossin, Robert

AU - Pascoe, Mark

AU - Paul, Ryan

AU - Peña, Alexia

AU - Price, Darrell

AU - Rodda, Christine

AU - Simmons, David

AU - Sinnott, Richard

AU - Sive, Alan

AU - Smart, Carmel

AU - Stone, Monique

AU - Stranks, Steve

AU - Tham, Elaine

AU - Verge, Charles

AU - Wales, Jerry

AU - Ward, Glenn

AU - Wheeler, Ben

AU - Williams, Judy

AU - Woodhead, Helen

AU - Woolfield, Nick

AU - Zimmermann, Anthony

PY - 2022/9

Y1 - 2022/9

N2 - Background: Competing challenges in adolescence and young adulthood can distract from optimal type 1 diabetes (T1D) self-management, and increase risks of premature morbidity and mortality. There are limited data mapping the glycemic control of people with T1D in this age group, across Australasia. Research Design and Methods: Clinical data were extracted from the Australasian Diabetes Data Network, a prospective clinical diabetes registry. Inclusion criteria were individuals with T1D aged 16–25 years at their last recorded T1D healthcare visit (from 1st January 2011 to 31st December 2020), with T1D duration of at least 1 year. Data were stratified by two last recorded T1D healthcare visit ranges, while generalized estimated equation (GEE) modeling was used to examine factors associated with HbA1c across visits during the 10 year period. Results: Data from 6329 young people (52.6% male) attending 24 diabetes centers across Australasia were included. At the last visit within the most recent 5 years, mean ± SD age was 18.5 ± 2.3 years, T1D duration was 8.8 ± 4.7 years and HbA1c was 8.8 ± 1.8% (72.2 ± 19.9 mmol/mol); only 12.3% had an HbA1c below the international target of <7.0% (53 mmol/mol). Across all T1D healthcare visits, in GEE modeling, higher HbA1c was associated with female sex (B = 0.20; 95% CI 0.12 to 0.29, p < 0.001), longer T1D duration (B = 0.04, 0.03 to 0.05, p < 0.001). Lower HbA1c was associated with attendance at a pediatric T1D healthcare setting (B = −0.33, −0.45 to −0.21, p < 0.001) and use of CSII versus BD/MDI therapy (B = −0.49, −0.59 to 0.40, p < 0.001). Conclusions: This Australasian study demonstrates widespread and persistent sub-optimal glycemic control in young people with T1D, highlighting the urgent need to better understand how healthcare services can support improved glycemic control in this population.

AB - Background: Competing challenges in adolescence and young adulthood can distract from optimal type 1 diabetes (T1D) self-management, and increase risks of premature morbidity and mortality. There are limited data mapping the glycemic control of people with T1D in this age group, across Australasia. Research Design and Methods: Clinical data were extracted from the Australasian Diabetes Data Network, a prospective clinical diabetes registry. Inclusion criteria were individuals with T1D aged 16–25 years at their last recorded T1D healthcare visit (from 1st January 2011 to 31st December 2020), with T1D duration of at least 1 year. Data were stratified by two last recorded T1D healthcare visit ranges, while generalized estimated equation (GEE) modeling was used to examine factors associated with HbA1c across visits during the 10 year period. Results: Data from 6329 young people (52.6% male) attending 24 diabetes centers across Australasia were included. At the last visit within the most recent 5 years, mean ± SD age was 18.5 ± 2.3 years, T1D duration was 8.8 ± 4.7 years and HbA1c was 8.8 ± 1.8% (72.2 ± 19.9 mmol/mol); only 12.3% had an HbA1c below the international target of <7.0% (53 mmol/mol). Across all T1D healthcare visits, in GEE modeling, higher HbA1c was associated with female sex (B = 0.20; 95% CI 0.12 to 0.29, p < 0.001), longer T1D duration (B = 0.04, 0.03 to 0.05, p < 0.001). Lower HbA1c was associated with attendance at a pediatric T1D healthcare setting (B = −0.33, −0.45 to −0.21, p < 0.001) and use of CSII versus BD/MDI therapy (B = −0.49, −0.59 to 0.40, p < 0.001). Conclusions: This Australasian study demonstrates widespread and persistent sub-optimal glycemic control in young people with T1D, highlighting the urgent need to better understand how healthcare services can support improved glycemic control in this population.

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U2 - 10.1111/pedi.13364

DO - 10.1111/pedi.13364

M3 - Article

C2 - 35561056

AN - SCOPUS:85133824572

SN - 1399-543X

VL - 23

SP - 736

EP - 741

JO - Pediatric Diabetes

JF - Pediatric Diabetes

IS - 6

ER -

Suboptimal glycemic control in adolescents and young adults with type 1 diabetes from 2011 to 2020 across Australia and New Zealand: Data from the Australasian Diabetes Data Network registry

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