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Persistent individual tracking within overall improvement in HbA 1c in a UK paediatric diabetes clinic over 15 years
Author(s) -
Edge J. A.,
James T.,
Shine B.
Publication year - 2010
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.1464-5491.2010.03057.x
Subject(s) - medicine , diabetes mellitus , pediatrics , rank correlation , endocrinology , computer science , machine learning
Diabet. Med. 27, 1284–1288 (2010) Abstract Introduction There is some evidence of long‐term tracking of HbA 1c levels within diabetes centres, but little evidence of individual tracking. Methods HbA 1c levels of children in the clinic over a period of 15 years were retrieved from the clinical chemistry laboratory information system. We measured the correlation of HbA 1c between years (Spearman and Pearson rank correlation), as well as the relationship of HbA 1c with age and the change over time in the clinic. Results Data were collected from 362 children and young people [158 female (44%)], aged 0–18 years (median 10.4 years), with 0–13.6 years of follow‐up (median 4.7 years). Mean HbA 1c levels fell from 9.3 ± 1.5% (78 ± 16 mmol/mol) in 2001 to 8.1 ± 1.3% (65 ± 14 mmol/mol) in 2009 in those at least 6 months after diagnosis ( P < 0.0001). HbA 1c levels gradually rise with increasing age. HbA 1c levels from year to year are significantly correlated. This is better for adjacent than subsequent years, but there is a significant correlation up to 9 years from diagnosis. Only 4 of 49 children with a 6‐month HbA 1c level of 9% (75 mmol/mol) or more had a long‐term (2–5 years) median HbA 1c < 8% (64 mmol/mol). Conclusions HbA 1c levels track in individuals within an improvement in overall clinic levels, suggesting that, if optimal control can be achieved in the first 6 months, it can persist for up to 9 years.