Demographic, Clinical, Management, and Outcome Characteristics of 8,004 Young Children With Type 1 Diabetes
Authors: Sandy Jessica L. , Tittel Sascha R. , Rompicherla Saketh , Karges Beate , James Steven , Rioles Nicole , Zimmerman Anthony G. , Fröhlich-Reiterer Elke , Maahs David M. , Lanzinger Stefanie , Craig Maria E. , Ebekozien Osagie ,   Australasian Diabetes Data Network (ADDN), Craig Maria , Colman Peter , Glastras Sarah , Jones Tim , Johnson Stephanie , Sinnott Richard , Zimmerman Anthony , Anderson Kym , Andrikopoulos Sof , Ambler Geoff , Batch Jennifer , Bergman Philip , Brown Justin , Cameron Fergus , Conwell Louise , Cotterill Andrew , Couper Jennifer , Davis Elizabeth , de Bock Martin , Donaghue Kim , Fairchild Jan , Fegan Gerry , Fourlanos Spiros , Goss Peter , Gray Leonie , Hamblin Shane , Hofman Paul , Holmes-Walker Dianne Jane , Huynh Tony , James Steven , Jefferies Craig , Kao Jeff , King Bruce R. , Lafferty Antony , Martin Michelle , McCrossin Robert , Neville Kris , Pascoe Mark , Paul Ryan , Peña Alexia , Phillips Liza , Price Darrell , Rodda Christine , Simmons David , Smart Carmel , Stone Monique , Stranks Steve , Tham Elaine , Ward Glenn , Wheeler Ben , Woodhead Helen ,   T1D Exchanged Quality Improvement Collaborative (T1DX-QI), Alonso G. Todd , DeSalvo Daniel , Miyazaki Brian , Choudhary Abha , Clements Mark , Majidi Shideh , Corathers Sarah , Mucci Andrea , Hsieh Susan , Cossen Kristina , Gallagher Mary Pat , Hannon Tamara , Wolf Risa , Bazan Grace , Fogel Naomi , Wilkes Meredith , Kamboj Manmohan , Sarhis Jennifer , Mekhoubad Allison , Accacha Siham , Guttmann-Bauman Ines , Demeterco-Berggren Carla , Malik Faisal , Roberts Alissa , Eng Donna , Prahalad Priya , Izquierdo Roberto , Crossen Stephanie , Schulmeister Caroline , Wong Jenise , Scott Mary Lauren , Jacobsen Laura , Sanchez Janine , Lee Joyce , Guarneri Alissa , Raman Vandana , Mann Liz , Antal Zoltan , Akturk Halis , Steenkamp Devin , Rao Pratibha , Vouyiouklis Mary , Agarwal Shivani , Davis Georgia , Mathioudakis Nestoras , Levy Carol , Aleppo Grazia , Golden Lauren , Ahmann Andrew , Lorincz Ilona , Basina Marina , Weinstock Ruth , Surampudi Prasanth , Kulasa Kristen , Masharani Umesh , Vendrame Francesco , Ng Jason , Zupa Margaret , Herrick Cynthia , Seyoum Berhane , Fantasia Kathryn , DiGiovanna Michael , Haw Sonya , Ziemer David , Garg Rajesh , Haft Howard , Tsai Sandra , Gangupantula Gopika ,   Prospective Diabetes Follow-Up Registry Initiative (DPV)
Published: February 2024

OBJECTIVE

To compare demographic, clinical, and therapeutic characteristics of children with type 1 diabetes age &lt;6 years across three international registries: Diabetes Prospective Follow-Up Registry (DPV; Europe), T1D Exchange Quality Improvement Network (T1DX-QI; U.S.), and Australasian Diabetes Data Network (ADDN; Australasia).

RESEARCH DESIGN AND METHODS

An analysis was conducted comparing 2019–2021 prospective registry data from 8,004 children.

RESULTS

Mean ± SD ages at diabetes diagnosis were 3.2 ± 1.4 (DPV and ADDN) and 3.7 ± 1.8 years (T1DX-QI). Mean ± SD diabetes durations were 1.4 ± 1.3 (DPV), 1.4 ± 1.6 (T1DX-QI), and 1.5 ± 1.3 years (ADDN). BMI z scores were in the overweight range in 36.2% (DPV), 41.8% (T1DX-QI), and 50.0% (ADDN) of participants. Mean ± SD HbA1c varied among registries: DPV 7.3 ± 0.9% (56 ± 10 mmol/mol), T1DX-QI 8.0 ± 1.4% (64 ± 16 mmol/mol), and ADDN 7.7 ± 1.2% (61 ± 13 mmol/mol). Overall, 37.5% of children achieved the target HbA1c of &lt;7.0% (53 mmol/mol): 43.6% in DPV, 25.5% in T1DX-QI, and 27.5% in ADDN. Use of diabetes technologies such as insulin pump (DPV 86.6%, T1DX 46.6%, and ADDN 39.2%) and continuous glucose monitoring (CGM; DPV 85.1%, T1DX-QI 57.6%, and ADDN 70.5%) varied among registries. Use of hybrid closed-loop (HCL) systems was uncommon (from 0.5% [ADDN] to 6.9% [DPV]).

CONCLUSIONS

Across three major registries, more than half of children age &lt;6 years did not achieve the target HbA1c of &lt;7.0% (53 mmol/mol). CGM was used by most participants, whereas insulin pump use varied across registries, and HCL system use was rare. The differences seen in glycemia and use of diabetes technologies among registries require further investigation to determine potential contributing factors and areas to target to improve the care of this vulnerable group.