@article{84312f7dbb7045efaa5f0931f16d3aff,
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.",
keywords = "adolescents, glycemic control, HbA1c, type 1 diabetes, young adults",
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 = "Funding Information: This research was conducted as part of the Australasian Diabetes Data Network (ADDN), which is supported by The Australian Type 1 Diabetes Clinical Research Network, led by Juvenile Diabetes Research Foundation (JDRF) Australia, the recipient of Australian Government funding from the Australian Research Council (through a Special Research Initiative) and the Department of Health and Aging. We are grateful to the children and young people with diabetes and their families who contribute to ADDN and to members of the ADDN Study Group who provided the data and reviewed the manuscript. 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 = "John Wiley & Sons",
number = "6",
}
