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A Nation‐wide Cross‐sectional Study of Glycosylated Haemoglobin in Danish Children with Type 1 diabetes
Author(s) -
Mortensen H. B.,
Hartling S. G.,
Petersen K. E.
Publication year - 1988
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1988.tb01127.x
Subject(s) - medicine , insulin , body mass index , diabetes mellitus , type 1 diabetes , type 2 diabetes , cross sectional study , endocrinology , el niño , pediatrics , pathology
A nation‐wide screening for HbA 1c was carried out in Denmark. Twenty‐one paediatric departments treating children with Type 1 diabetes participated. During a period of 4 months 884 children were included, 93% of all those followed at these centres, representing approximately 70–80% of all children and adolescents with Type 1 diabetes in Denmark. Among the children 351 were ≤ 12 years and 533 were adolescents between 12 and 18 years. Children ≤ 12 years had a HbA 1c concentration of 8.9 ± 1.5 (± SD)% and an insulin dose of 0.71 ± 0.3 U kg −1 24‐h −1 . For adolescents HbA 1c was significantly higher 9.7 ± 2.0% ( p < 0.001) and insulin dose significantly increased 0.85 ± 0.3 U kg −1 24‐h −1 ( p < 0.001). Normal range for HbA 1c ' is 4.0–6.5 (mean 5.3)% of total haemoglobin. Boys and girls ≤ 12 years had similar HbA 1c ' but girls received 13% more insulin ( p < 0.001). In the group of adolescents, girls had a HbA 1c 4% higher than boys (9.9 ± 2.0 vs 9.5 ± 2.0% p < 0.025), received 11% more insulin ( p < 0.001), and had 6% higher body mass index ( p < 0.001). A weak correlation was found between insulin dose and the HbA 1c level ( r = 0.29, p < 0.001). Children and adolescents on four or more injections daily received significantly more insulin ( p < 0.001) than those on conventional treatment and had a significantly higher body mass index ( p < 0.001). These changes were most pronounced for girls who, despite receiving 15% more insulin, had a significantly higher HbA 1c level (9.9 ± 1.8 vs 9.3 ± 1.9%, p < 0.005) and 12% higher body mass index ( p < 0.001). Furthermore standard deviation score for height decreased with longer duration of the disease and more so in children with the highest HbA 1c values. Our data confirm that current treatment of childhood diabetes in Denmark produces unsatisfactory results.