Exploring Variation in Glycemic Control Across and Within Eight High-Income Countries: A Cross-sectional Analysis of 64,666 Children and Adolescents With Type 1 Diabetes
| Autor: | Siv J Kummernes, Ann-Marie Svensson, Terence Stephenson, Dimitrios Charalampopoulos, Knut Dahl-Jørgensen, Niels H Birkebaek, Lena Hanberger, Torild Skrivarhaug, Anders Johansen, Julia M. Hermann, Nicole C. Foster, Sabine E. Hofer, Birgit Rami-Merhar, Justin T. Warner, Rakesh Amin, Ragnar Hanas, Reinhard W. Holl, Siri Fredheim, Karin Åkesson, Mark A. Clements, David M. Maahs, Jannet Svensson, Kellee M. Miller, A K Drivvoll |
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| Rok vydání: | 2018 |
| Předmět: |
Blood Glucose
Male Research design Cross-sectional study Intraclass correlation Denmark Endocrinology Diabetes and Metabolism Glycated Hemoglobin A/analysis 0302 clinical medicine Germany 030212 general & internal medicine Child Minority Groups Wales/epidemiology Norway Norway/epidemiology Pooled analysis England Minority Groups/statistics & numerical data Austria Income Female High income countries Adolescent Germany/epidemiology Developed Countries/economics 030209 endocrinology & metabolism 03 medical and health sciences Diabetes mellitus Internal Medicine medicine Humans Income/statistics & numerical data Epidemiology/Health Services Research Austria/epidemiology England/epidemiology Glycemic Glycated Hemoglobin Sweden Advanced and Specialized Nursing Type 1 diabetes Wales Blood Glucose/metabolism business.industry Developed Countries Diabetes Mellitus Type 1/blood medicine.disease Denmark/epidemiology Diabetes Mellitus Type 1 Cross-Sectional Studies Sweden/epidemiology business Demography |
| Zdroj: | Charalampopoulos, D, Hermann, J M, Svensson, J, Skrivarhaug, T, Maahs, D M, Akesson, K, Warner, J T, Holl, R W, Birkebæk, N H, Drivvoll, A K, Miller, K M, Svensson, A-M, Stephenson, T, Hofer, S E, Fredheim, S, Kummernes, S J, Foster, N, Hanberger, L, Amin, R, Rami-Merhar, B, Johansen, A, Dahl-Jørgensen, K, Clements, M & Hanas, R 2018, ' Exploring Variation in Glycemic Control Across and Within Eight High-Income Countries : A Cross-Sectional Analysis of 64,666 Children and Adolescents With Type 1 Diabetes ', Diabetes Care, vol. 41, no. 6, pp. 1180-1187 . https://doi.org/10.2337/dc17-2271 |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/dc17-2271 |
| Popis: | OBJECTIVE International studies on childhood type 1 diabetes (T1D) have focused on whole-country mean HbA1c levels, thereby concealing potential variations within countries. We aimed to explore the variations in HbA1c across and within eight high-income countries to best inform international benchmarking and policy recommendations. RESEARCH DESIGN AND METHODS Data were collected between 2013 and 2014 from 64,666 children with T1D who were RESULTS Sweden had the lowest mean HbA1c (59 mmol/mol [7.6%]) and together with Norway and Denmark showed the lowest between-center variations (ICC ≤4%). Germany and Austria had the next lowest mean HbA1c (61–62 mmol/mol [7.7–7.8%]) but showed the largest center variations (ICC ∼15%). Centers in England, Wales, and the U.S. showed low-to-moderate variation around high mean values. In pooled analysis, differences between counties remained significant after adjustment for children characteristics and center effects (P value CONCLUSIONS At similar average levels of HbA1c, countries display different levels of center variation. The distribution of glycemic achievement within countries should be considered in developing informed policies that drive quality improvement. |
| Databáze: | OpenAIRE |
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