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Five years of improving diabetes control in Czech children after the establishment of the population‐based childhood diabetes register ČENDA
Author(s) -
Šumník Zdeněk,
Venháčová Jitřenka,
Škvor Jaroslav,
Pomahačová Renata,
Konečná Petra,
Neumann David,
Vosáhlo Jan,
Strnadel Jiří,
Čížek Jindřich,
Obermannová Barbora,
Petruželková Lenka,
Průhová Štěpánka,
Pavlíková Markéta,
Cinek Ondřej
Publication year - 2020
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.12929
Subject(s) - medicine , diabetes mellitus , glycated hemoglobin , pediatrics , type 1 diabetes , confidence interval , czech , population , type 2 diabetes , endocrinology , environmental health , linguistics , philosophy
Objectives The Czech National Childhood Diabetes Register (ČENDA) is a web‐based nationwide database that collects treatment and outcome data in children and adolescents with diabetes. Here, we present data from the first 5 years of ČENDA (2013‐2017). Methods Data include characteristics of disease onset and annual summaries of key clinical care parameters from every patient treated by participating pediatric diabetes outpatient clinics. Results The database contains data of 4361 children (aged 0‐19 years) from 52 centers (85% of all Czech pediatric patients). Of these, 94% had type 1 diabetes (T1D), 4.5% had genetically proven monogenic or secondary, and 1.5% had type 2 diabetes. In children with T1D, median glycated hemoglobin (HbA1c) decreased throughout the observed period from 66.3 to 61.0 mmol/mol ( P < .0001, 95% confidence interval [CI] for change −5.6 to −4 mmol/mol). Consequently, the proportion of children reaching the target therapeutic goal of 58.5 mmol/mol increased from 28% in 2013 to 40% in 2017. The proportion of children treated with insulin pumps (CSII) remained stable over the observed period (25%). In a subanalysis of 1602 patients (long‐standing T1D diagnosed before 2011), the main predictors associated with lower HbA1c were treatment with CSII, male sex and care provided at a large diabetes center (>100 patients). Conclusions A significant continuous decrease in HbA1c was observed in Czech children over the past 5 years. As this improvement was not accompanied by appreciable changes in the mode of therapy, we assume that the establishment of our nationwide register has itself constituted a stimulus towards improvement in the care process.