Background: Mean HbA1c in children and adolescents varies between countries, but there is a considerable variation also between clinics within the same country. It has been difficult to characterize factors that contribute to this difference. We aimed to compare early metabolic control with long-term mean HbA1c in clinics within Sweden.

Methods: The Swedish pediatric diabetes quality registry (SWEDIABKIDS) covers 98% of children and adolescents < 18 years in Sweden. We captured overall mean HbA1c for 36/42 clinics (6 had less than 20 patients with < 2 years’ duration) and compared with HbA1c over the first 2 years of diabetes. Values with < 3 months’ duration were not included as these are affected by glucose levels before diagnosis.

Results: Mean overall HbA1c for all 42 clinics was 54.6 (95% CI 53.3-55.9) mmol/mol (7.1%, 95% CI 7.0-7.3) and over the first 2 years for the 36 clinics 50.1 (95% CI 48.0-52.2) mmol/mol (6.7%, 95% CI 6.5-6.9). The correlation for the 36 clinics was r=0.677 (p<0.001). R2 was 0.458, i.e., 45.8% of the variation in overall HbA1c was explained by HbA1c during the first 2 years of diabetes.

Conclusions: An intensive education program at the onset of diabetes resulting in a low HbA1c early on is a good investment for the long-term metabolic control. Mean HbA1c during the first 2 years will be a good variable to measure the effectiveness and success on a clinic level of new implementations in diabetes treatments.


R. Hanas: Advisory Panel; Self; Insulet Corporation. Speaker's Bureau; Self; Novo Nordisk A/S. Other Relationship; Self; AstraZeneca. L. Hanberger: None. U. Samuelsson: None. K. Åkesson: Speaker's Bureau; Self; Novo Nordisk A/S.

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