International comparison of glycaemic control in people with type 1 diabetes: an update and extension

Regina Prigge, John A. McKnight, Sarah H. Wild, Aveni Haynes, Timothy W. Jones, Elizabeth A. Davis, Birgit Rami-Merhar, Maria Fritsch, Christine Prchla, Astrid Lavens, Kris Doggen, Suchsia Chao, Ronnie Aronson, Ruth Brown, Else H. Ibfelt, Jannet Svensson, Robert Young, Justin T. Warner, Holy Robinson, Tiina LaatikainenPäivi Rautiainen, Brigitte Delemer, Pierre François Souchon, Alpha M. Diallo, Reinhard W. Holl, Sebastian M. Schmid, Klemens Raile, Stelios Tigas, Alexandra Bargiota, Ioanna Zografou, Andrea O.Y. Luk, Juliana C.N. Chan, Sean F. Dinneen, Claire M. Buckley, Oratile Kgosidialwa, Valentino Cherubini, Rosaria Gesuita, Ieva Strele, Santa Pildava, Henk Veeze, Henk Jan Aanstoot, Dick Mul, Craig Jefferies, John G. Cooper, Karianne Fjeld Løvaas, Tadej Battelino, Klemen Dovc, Nataša Bratina, Katarina Eeg-Olofsson, Ann Marie Svensson, Soffia Gudbjornsdottir, Evgenia Globa, Nataliya Zelinska

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24 Citations (Scopus)


AIMS: To update and extend a previous cross-sectional international comparison of glycaemic control in people with type 1 diabetes. METHODS: Data were obtained for 520,392 children and adults with type 1 diabetes from 17 population and five clinic-based data sources in countries or regions between 2016 and 2020. Median HbA1c (IQR) and proportions of individuals with HbA1c < 58 mmol/mol (<7.5%), 58-74 mmol/mol (7.5-8.9%) and ≥75 mmol/mol (≥9.0%) were compared between populations for individuals aged <15, 15-24 and ≥25 years. Logistic regression was used to estimate the odds ratio (OR) of HbA1c < 58 mmol/mol (<7.5%) relative to ≥58 mmol/mol (≥7.5%), stratified and adjusted for sex, age and data source. Where possible, changes in the proportion of individuals in each HbA1c category compared to previous estimates were calculated. RESULTS: Median HbA1c varied from 55 to 79 mmol/mol (7.2 to 9.4%) across data sources and age groups so a pooled estimate was deemed inappropriate. OR (95% CI) for HbA1c < 58 mmol/mol (<7.5%) were 0.91 (0.90-0.92) for women compared to men, 1.68 (1.65-1.71) for people aged <15 years and 0.81 (0.79-0.82) aged15-24 years compared to those aged ≥25 years. Differences between populations persisted after adjusting for sex, age and data source. In general, compared to our previous analysis, the proportion of people with an HbA1c  < 58 mmol/l (<7.5%) increased and proportions of people with HbA1c ≥ 75 mmol/mol (≥9.0%) decreased. CONCLUSIONS: Glycaemic control of type 1 diabetes continues to vary substantially between age groups and data sources. While some improvement over time has been observed, glycaemic control remains sub-optimal for most people with Type 1 diabetes.

Original languageEnglish
Article numbere14766
JournalDiabetic medicine : a journal of the British Diabetic Association
Issue number5
Publication statusPublished - 1 May 2022


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