#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Continuing improvement in metabolic control in Czech children with type 1 diabetes: data from the ČENDA registry (2013–2020)


Authors: Šumník Zdeněk 1;  Konečná Petra 2;  Venháčová Petra 3;  Neumann David 4;  Škvor Jaroslav 5;  Renata;  Pomahačová 6;  Strnadel Jiří 7;  Průhová Štěpánka 1;  Petruželková Lenka 1;  Vosáhlo Jan 8;  Kocourková Kamila 9;  Pavlíková Markéta 10;  Cinek Ondřej 1;  Čenda Konsorcium Za
Authors place of work: Pediatrická klinika 2. LF UK, a FN v Motole, Praha 1;  Pediatrická klinika FN a LF, MU, Brno 2;  Dětská klinika FN a LF UP, Olomouc 3;  Dětská klinika FN a LF UK, Hradec Králové 4;  Dětská klinika Masarykovy, nemocnice a IPVZ, Ústí nad Labem 5;  Dětská klinika FN a LF UK, Plzeň 6;  Dětská klinika FN a LF OU, Ostrava 7;  Klinika dětí a dorostu, 3. LF UK a FNKV, Praha 8;  Dětská klinika Nemocnice, České Budějovice 9;  Katedra pravděpodobnosti, a statistiky, MFF UK, Praha 10
Published in the journal: Čes-slov Pediat 2022; 77 (2): 64-71.
Category: Original Papers

Summary

Introduction: Diabetes belongs to the most common chronic diseases in childhood. Web-based national longitudinal pediatric diabetes registry (ČENDA) was established in 2013 by the joint efforts of Czech centers of pediatric diabetes. Since then, the ČENDA registry represents an important source of data on the course, control, therapy and complications of diabetes in children and adolescents. This paper summarizes trends in key parameters of diabetes control over the first 8 years of the ČENDA registry.

Results: In 2020, the register contained data from 3818 patients, i. e. approximately 90% of children with diabetes in the Czech Republic. The registry data shows a decreasing trend in HbA1c in children with Type 1 diabetes - the mean HbA1c dropped by 12 mmol/mol from 66.6 mmol/mol in 2013 to 54.7 mmol/mol in 2020 (p < 0.001). This change was accompanied by a reduction in the incidence of acute diabetic complications. Main predictors associated with lower HbA1c were treatment using modern technologies (insulin pumps and continuous glucose monitors), male sex, and care provided at a large diabetes center.

Conclusion: The prognosis of Czech children with type 1 diabetes has significantly improved in recent years. The introduction of modern technologies into clinical practice and the establishment of the ČENDA registry have very likely contributed to this positive trend.

Keywords:

registry – HbA1c – Epidemiology – type 1 diabetes – children


Zdroje

1. Patterson CC, Harjutsalo V, Rosenbauer J, et al. Trends and cyclical variation in the incidence of childhood type 1 diabetes in 26 European centres in the 25 year period 1989–2013: a multicentre prospective registration study. Diabetologia 2019; 62(3): 408–417.

2. Cinek O, Šumník Z, Vavřinec J. Childhood diabetes in the Czech Republic: a steady increase in incidence. Cas Lek Cesk 2005; 144(4): 266–71.

3. Cinek O, Kulich M, Šumník Z. The incidence of type 1 diabetes in young Czech children stopped rising. Pediatr Diabetes 2012; 13(7): 559–63.

4. McEwen LN, Casagrande SS, Kuo S, Herman WH. Why are diabetes medications so expensive and what can be done to control their cost? Curr Diab Rep 2017; 17(9): 71.

5. Mayer-Davis EJ, Kahkoska AR, Jefferies C, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes 2018; 19(Suppl 27): 7–19.

6. Zeitler P, Arslanian S, Fu J, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Type 2 diabetes mellitus in youth. Pediatr Diabetes 2018; 19(Suppl 27): 28–46.

7. Rawshani A, Sattar N, Franzén S, et al. Excess mortality and cardiovascular disease in young adults with type 1 diabetes in relation to age at onset: a nationwide, register–based cohort study. Lancet 2018; 392(10146): 477–486.

8. DiMeglio LA, Acerini CL, Codner E, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Glycemic control targets and glucose monitoring for children, adolescents, and young adults with diabetes. Pediatr Diabetes 2018; 19(Suppl 27): 105–114.

9. Foster NC, Beck RW, Miller KM, et al. State of type 1 diabetes management and outcomes from the T1D Exchange in 2016–2018. Diabetes Technol Ther 2019; 21(2): 66–72.

10. Šumník Z, Venháčová J, Škvor J, et al.; ČENDA Project Group. Five years of improving diabetes control in Czech children after the establishment of the population–based childhood diabetes register CENDA. Pediatr Diabetes 2020; 21(1): 77–87.

11. Šumník Z, Pavlíková M, Pomahačová R, et al.; ČENDA Project Group. Use of continuous glucose monitoring and its association with type 1 diabetes control in children over the first 3 years of reimbursement approval: Population data from the CENDA registry. Pediatr Diabetes 2021; 22(3): 439–447.

12. Battelino T, Danne T, Bergenstal RM, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes Care 2019; 42(8): 1593–1603.

13. Braffett BH, Gubitosi-Klug RA, Albers JW, et al. Risk factors for diabetic peripheral neuropathy and cardiovascular autonomic neuropathy in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study. Diabetes 2020; 69(5): 1000–1010.

14. Bebu I, Schade D, Braffett B, et al. Risk factors for first and subsequent CVD events in type 1 diabetes: The DCCT/EDIC Study. Diabetes Care 2020; 43(4): 867–874.

15. Jacobson AM, Ryan CM, Braffett BH, et al.; DCCT/EDIC Research Group. Cognitive performance declines in older adults with type 1 diabetes: results from 32 years of follow– up in the DCCT and EDIC Study. Lancet Diabetes Endocrinol 2021; 9(7): 436–445.

16. Lind M, Pivodic A, Svensson AM, et al. HbA(1c) level as a risk factor for retinopathy and nephropathy in children and adults with type 1 diabetes: Swedish population based cohort study. BMJ 2019; 366: l4894.

17. Hermann JM, Miller KM, Hofer SE, et al.; T1D Exchange Clinic Network and the DPV initiative. The Transatlantic HbA(1c) gap: differences in glycaemic control across the lifespan between people included in the US T1D Exchange Registry and those included in the German/Austrian DPV registry. Diabet Med 2020; 37(5): 848–855.

18. Danne T, Lanzinger S, de Bock M, et al. A worldwide perspective on COVID-19 and diabetes management in 22,820 children from the SWEET Project: diabetic ketoacidosis rates increase and glycemic control is maintained. Diabetes Technol Ther 2021; 23(9): 632–641.

19. Miller KM, Foster NC, Beck RW, et al.; T1D Exchange Clinic Network. Current state of type 1 diabetes treatment in the U.S.: updated data from the T1D Exchange clinic registry. Diabetes Care 2015; 38(6): 971–8.

20. Samuelsson U, Åkesson K, Peterson A, et al. Continued improvement of metabolic control in Swedish pediatric diabetes care. Pediatr Diabetes. 2018; 19(1): 150–157.

21. Skipper N, Thingholm PR, Borch L, et al. Center differences in diabetes treatment outcomes among children with type 1 diabetes: A nationwide study of 3866 Danish children. Pediatr Diabetes 2021. doi: 10.1111/pedi.13284

22. Šumník Z, Szypowska A, Iotova V, et al.; SWEET study group. Persistent heterogeneity in diabetes technology reimbursement for children with type 1 diabetes: The SWEET perspective. Pediatr Diabetes 2019; 20(4): 434– 443.

23. Birkebaek NH, Hermann JM, Hanberger L, et al. Center size and glycemic control: an international study with 504 centers from seven countries. Diabetes Care 2019; 42(3): e37–e39.

24. Věstník Ministerstva zdravotnictví ČR 08/2019 ze dne 30. 8. 2019. Dostupné na: https: //www.mzcr.cz/vestnik/vestnik– c–8–2019/

Štítky
Neonatology Paediatrics General practitioner for children and adolescents

Článok vyšiel v časopise

Czech-Slovak Pediatrics

Číslo 2

2022 Číslo 2
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#