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

OBJECTIVE To compare demographic, clinical, and therapeutic characteristics of children with type 1 diabetes age &amp;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 &amp;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 &amp;lt;6 years did not achieve the target HbA1c of &amp;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.