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Association of diabetic ketoacidosis and HbA1c at onset with year‐three HbA1c in children and adolescents with type 1 diabetes: Data from the International SWEET Registry
Author(s) -
Piccini Barbara,
Schwandt Anke,
Jefferies Craig,
Kordonouri Olga,
Limbert Catarina,
Arslanoglu Ilknur,
CardonaHernandez Roque,
Coutant Regis,
Kim Jae Hyun,
Preiksa Romualdas T.,
Pundziute Lyckå Auste,
RamiMerhar Birgit,
Richmond Erick,
Savova Radka,
Todorovic Sladjana,
Veeze Henk J.,
Toni Sonia
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.12946
Subject(s) - medicine , diabetic ketoacidosis , type 1 diabetes , coma (optics) , pediatrics , diabetes mellitus , age of onset , ketoacidosis , endocrinology , physics , disease , optics
Abstract Objective To establish whether diabetic ketoacidosis (DKA) or HbA1c at onset is associated with year‐three HbA1c in children with type 1 diabetes (T1D). Methods Children with T1D from the SWEET registry, diagnosed <18 years, with documented clinical presentation, HbA1c at onset and follow‐up were included. Participants were categorized according to T1D onset: (a) DKA (DKA with coma, DKA without coma, no DKA); (b) HbA1c at onset (low [<10%], medium [10 to <12%], high [≥12%]). To adjust for demographics, linear regression was applied with interaction terms for DKA and HbA1c at onset groups (adjusted means with 95% CI). Association between year‐three HbA1c and both HbA1c and presentation at onset was analyzed (Vuong test). Results Among 1420 children (54% males; median age at onset 9.1 years [Q1;Q3: 5.8;12.2]), 6% of children experienced DKA with coma , 37% DKA without coma , and 57% no DKA . Year‐three HbA1c was lower in the low compared to high HbA1c at onset group, both in the DKA without coma (7.1% [6.8;7.4] vs 7.6% [7.5;7.8], P = .03) and in the no DKA group (7.4% [7.2;7.5] vs 7.8% [7.6;7.9], P = .01), without differences between low and medium HbA1c at onset groups. Year‐three HbA1c did not differ among HbA1c at onset groups in the DKA with coma group. HbA1c at onset as an explanatory variable was more closely associated with year‐three HbA1c compared to presentation at onset groups ( P = .02). Conclusions Year‐three HbA1c is more closely related to HbA1c than to DKA at onset; earlier hyperglycemia detection might be crucial to improving year‐three HbA1c.