Background: The mean HbA1c in children and adolescents varies between countries, but there is a considerable variation also between clinics within a country. The Swedish HbA1c target in children and adolescents is ≤6.5% (48 mmol/mol). Our aim was to compare early metabolic control with percentage of patients with HbA1c ≤6.5% (A1c6.5) and >8.0% (64 mmol/mol) (A1c8) for all clinics in Sweden.
Methods: In this register-based nationwide cohort with type 1 diabetes, 98% of children and adolescents <18 years in Sweden were covered. We captured HbA1c for all patients (last value recorded in 2019) and calculated the mean. We then compared the mean HbA1c of all patients with up to 2 years duration with the percentage of patients with A1c6.5 and A1c8.
Results: Mean overall HbA1c was 7.0% (95% CI 7.0-7.1) (53.3 mmol/mol, 95% CI 52.6-54.0) (n=7433) and for those with 0-2 years' duration 6.6% (95% CI 6.5-6.7) (49.1 mmol/mol, (95% CI 48.2-50.0) (n=1911). The mean overall percentage of patients with A1c6.5 was 35.3% (95% CI 32.4-38.2) (n=2575) and A1c8 was 13.2 (95% CI 11.5-14.8) (n=958). The correlation between mean HbA1c 0-2 y. and A1c6.5 was -0.80 (p<0.001) and A1c8 0.48 (p=0.004).
Conclusions: An intensive treatment program at the onset of diabetes resulting in a low HbA1c early on is a good investment to increase HbA1c values within target and to minimize high HbA1c values.
R. Hanas: Advisory Panel; Self; Abbott, Novo Nordisk A/S. Speaker’s Bureau; Self; Sanofi. Other Relationship; Self; AstraZeneca. L. Hanberger: None. U. Samuelsson: None. A. Svensson: None. K. Akesson: None.