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

S. James; L. Perry; J. Lowe; M. Harris; M. E. Craig; K. Anderson; S. Andrikopoulos; G. Ambler; H. Barrett; J. Batch; P. Bergman; F. Cameron; P. Colman; L. Conwell; A. Cotterill; C. Cooper; J. Couper; E. Davis; M. de Bock; K. Donaghue; J. Fairchild; G. Fegan; S. Fourlanos; S. Glastras; L. Gray; S. Hamblin; P. Hofman; D. J. Holmes-Walker; N. Howard; M. Jack; C. Jefferies; T. Jones; S. Johnson; J. Kao; B. R. King; A. Lafferty; M. Martin; R. McCrossin; M. Pascoe; R. Paul; A. Peña; D. Price; C. Rodda; David Simmons; R. Sinnott; A. Sive; C. Smart; M. Stone; S. Stranks; E. Tham; C. Verge; J. Wales; G. Ward; B. Wheeler; J. Williams; H. Woodhead; N. Woolfield; A. Zimmermann; null ADDN study group

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

S. James, L. Perry, J. Lowe, M. Harris, M. E. Craig, K. Anderson, S. Andrikopoulos, G. Ambler, H. Barrett, J. Batch, P. Bergman, F. Cameron, P. Colman, L. Conwell, A. Cotterill, C. Cooper, J. Couper, E. Davis, M. de Bock, K. DonaghueJ. Fairchild, G. Fegan, S. Fourlanos, S. Glastras, L. Gray, S. Hamblin, P. Hofman, D. J. Holmes-Walker, N. Howard, M. Jack, C. Jefferies, T. Jones, S. Johnson, J. Kao, B. R. King, A. Lafferty, M. Martin, R. McCrossin, M. Pascoe, R. Paul, A. Peña, D. Price, C. Rodda, David Simmons, R. Sinnott, A. Sive, C. Smart, M. Stone, S. Stranks, E. Tham, C. Verge, J. Wales, G. Ward, B. Wheeler, J. Williams, H. Woodhead, N. Woolfield, A. Zimmermann, ADDN study group

Western Sydney University

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

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 Â± SD age was 18.5 Â± 2.3 years, T1D duration was 8.8 Â± 4.7 years and HbA1c was 8.8 Â± 1.8% (72.2 Â± 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 (BÂ =Â 0.20; 95% CI 0.12 to 0.29, p < 0.001), longer T1D duration (BÂ =Â 0.04, 0.03 to 0.05, p < 0.001). Lower HbA1c was associated with attendance at a pediatric T1D healthcare setting (BÂ =Â −0.33, −0.45 to −0.21, p < 0.001) and use of CSII versus BD/MDI therapy (BÂ =Â −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 - 2022

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10.1111/pedi.13364

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James, S., Perry, L., Lowe, J., Harris, M., Craig, M. E., Anderson, K., Andrikopoulos, S., Ambler, G., Barrett, H., Batch, J., Bergman, P., Cameron, F., Colman, P., Conwell, L., Cotterill, A., Cooper, C., Couper, J., Davis, E., de Bock, M., ... ADDN study group (2022). 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. Pediatric Diabetes, 23(6), 736-741. https://doi.org/10.1111/pedi.13364

@article{4e4cb92e046b4b2b90bb0c3c413f1ea2,

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 {\^A}± SD age was 18.5 {\^A}± 2.3 years, T1D duration was 8.8 {\^A}± 4.7 years and HbA1c was 8.8 {\^A}± 1.8% (72.2 {\^A}± 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{\^A} ={\^A} 0.20; 95% CI 0.12 to 0.29, p < 0.001), longer T1D duration (B{\^A} ={\^A} 0.04, 0.03 to 0.05, p < 0.001). Lower HbA1c was associated with attendance at a pediatric T1D healthcare setting (B{\^A} ={\^A} −0.33, −0.45 to −0.21, p < 0.001) and use of CSII versus BD/MDI therapy (B{\^A} ={\^A} −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 = "S. James and L. Perry and J. Lowe and M. Harris and Craig, {M. E.} and K. Anderson and S. Andrikopoulos and G. Ambler and H. Barrett and J. Batch and P. Bergman and F. Cameron and P. Colman and L. Conwell and A. Cotterill and C. Cooper and J. Couper and E. Davis and {de Bock}, M. and K. Donaghue and J. Fairchild and G. Fegan and S. Fourlanos and S. Glastras and L. Gray and S. Hamblin and P. Hofman and Holmes-Walker, {D. J.} and N. Howard and M. Jack and C. Jefferies and T. Jones and S. Johnson and J. Kao and King, {B. R.} and A. Lafferty and M. Martin and R. McCrossin and M. Pascoe and R. Paul and A. Pe{\~n}a and D. Price and C. Rodda and David Simmons and R. Sinnott and A. Sive and C. Smart and M. Stone and S. Stranks and E. Tham and C. Verge and J. Wales and G. Ward and B. Wheeler and J. Williams and H. Woodhead and N. Woolfield and A. Zimmermann and {ADDN study group}",

year = "2022",

doi = "10.1111/pedi.13364",

language = "English",

volume = "23",

pages = "736--741",

journal = "Pediatric Diabetes",

issn = "1399-543X",

publisher = "Wiley-Blackwell Publishing",

number = "6",

}

James, S, Perry, L, Lowe, J, Harris, M, Craig, ME, Anderson, K, Andrikopoulos, S, Ambler, G, Barrett, H, Batch, J, Bergman, P, Cameron, F, Colman, P, Conwell, L, Cotterill, A, Cooper, C, Couper, J, Davis, E, de Bock, M, Donaghue, K, Fairchild, J, Fegan, G, Fourlanos, S, Glastras, S, Gray, L, Hamblin, S, Hofman, P, Holmes-Walker, DJ, Howard, N, Jack, M, Jefferies, C, Jones, T, Johnson, S, Kao, J, King, BR, Lafferty, A, Martin, M, McCrossin, R, Pascoe, M, Paul, R, Peña, A, Price, D, Rodda, C, Simmons, D, Sinnott, R, Sive, A, Smart, C, Stone, M, Stranks, S, Tham, E, Verge, C, Wales, J, Ward, G, Wheeler, B, Williams, J, Woodhead, H, Woolfield, N, Zimmermann, A & ADDN study group 2022, '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', Pediatric Diabetes, vol. 23, no. 6, pp. 736-741. https://doi.org/10.1111/pedi.13364

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 - James, S.

AU - Perry, L.

AU - Lowe, J.

AU - Harris, M.

AU - Craig, M. E.

AU - Anderson, K.

AU - Andrikopoulos, S.

AU - Ambler, G.

AU - Barrett, H.

AU - Batch, J.

AU - Bergman, P.

AU - Cameron, F.

AU - Colman, P.

AU - Conwell, L.

AU - Cotterill, A.

AU - Cooper, C.

AU - Couper, J.

AU - Davis, E.

AU - de Bock, M.

AU - Donaghue, K.

AU - Fairchild, J.

AU - Fegan, G.

AU - Fourlanos, S.

AU - Glastras, S.

AU - Gray, L.

AU - Hamblin, S.

AU - Hofman, P.

AU - Holmes-Walker, D. J.

AU - Howard, N.

AU - Jack, M.

AU - Jefferies, C.

AU - Jones, T.

AU - Johnson, S.

AU - Kao, J.

AU - King, B. R.

AU - Lafferty, A.

AU - Martin, M.

AU - McCrossin, R.

AU - Pascoe, M.

AU - Paul, R.

AU - Peña, A.

AU - Price, D.

AU - Rodda, C.

AU - Simmons, David

AU - Sinnott, R.

AU - Sive, A.

AU - Smart, C.

AU - Stone, M.

AU - Stranks, S.

AU - Tham, E.

AU - Verge, C.

AU - Wales, J.

AU - Ward, G.

AU - Wheeler, B.

AU - Williams, J.

AU - Woodhead, H.

AU - Woolfield, N.

AU - Zimmermann, A.

AU - ADDN study group, null

PY - 2022

Y1 - 2022

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 Â± SD age was 18.5 Â± 2.3 years, T1D duration was 8.8 Â± 4.7 years and HbA1c was 8.8 Â± 1.8% (72.2 Â± 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 (BÂ =Â 0.20; 95% CI 0.12 to 0.29, p < 0.001), longer T1D duration (BÂ =Â 0.04, 0.03 to 0.05, p < 0.001). Lower HbA1c was associated with attendance at a pediatric T1D healthcare setting (BÂ =Â −0.33, −0.45 to −0.21, p < 0.001) and use of CSII versus BD/MDI therapy (BÂ =Â −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 Â± SD age was 18.5 Â± 2.3 years, T1D duration was 8.8 Â± 4.7 years and HbA1c was 8.8 Â± 1.8% (72.2 Â± 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 (BÂ =Â 0.20; 95% CI 0.12 to 0.29, p < 0.001), longer T1D duration (BÂ =Â 0.04, 0.03 to 0.05, p < 0.001). Lower HbA1c was associated with attendance at a pediatric T1D healthcare setting (BÂ =Â −0.33, −0.45 to −0.21, p < 0.001) and use of CSII versus BD/MDI therapy (BÂ =Â −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.

UR - https://hdl.handle.net/1959.7/uws:75715

U2 - 10.1111/pedi.13364

DO - 10.1111/pedi.13364

M3 - Article

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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