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Glycemic control and complications in patients with type 1 diabetes – a registry‐based longitudinal study of adolescents and young adults
Author(s) -
Carlsen Siri,
Skrivarhaug Torild,
Thue Geir,
Cooper John G.,
Gøransson Lasse,
Løvaas Karianne,
Sandberg Sverre
Publication year - 2017
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12372
Subject(s) - medicine , glycemic , diabetes mellitus , type 1 diabetes , pediatrics , type 2 diabetes , young adult , endocrinology
Objective The main aims of this study were to assess longitudinal glycemic control and the prevalence of retinopathy and nephropathy in young people (aged 14–30 yr) with type 1 diabetes in Norway. Method Data on 874 patients were obtained by linking two nationwide, population‐based medical quality registries: The Norwegian Diabetes Register for Adults and The Norwegian Childhood Diabetes Registry. Results Median age was 23 yr, median diabetes duration 9 yr and 51% were male. Median HbA 1c increased through adolescence to peak at ages of 17 yr for females and 19 yr for males, females had higher HbA 1c than males: 9.3% (78 mmol/mol) vs. 9.1% (76 mmol/mol). Subsequently, median HbA 1c declined but was still >8% (>64 mmol/mol) for patients approaching 30 yr. Half of the patients aged 14–17 yr and 40% of patients aged 18–25 yr had HbA 1c >9% (75 mmol/mol). Retinopathy was found in 16% and nephropathy in 13% of the population. Patients transferring from the pediatric department to adult care between the ages of 14 and 17 yr had higher median HbA 1c and prevalence of late complications than those transferring at ages 18–22 yr. Less than 40% of patients with albuminuria were treated with ACE inhibitors or angiotensin II receptor blocker. Conclusion Our results demonstrate that treatment of adolescents and young adults with type 1 diabetes in Norway is not optimal, especially for patients in their late teens. We suggest that pediatricians and endocrinologists should critically assess the care offered to this group and consider new approaches to help them improve glycemic control.