Differences in Achieving Stringent Glycemic Targets Among Youth with Type 1 Diabetes: A SWEET Registry Study
Klemen Dovc, Beata Mianowska, Claudia Boettcher, Roque Cardona-Hernandez, Thekla von dem Berge, Elizabeth Davis, Ioanna Kosteria, Marco Marigliano, Birgit Rami-Merhar, Mauro Scharf, Stefanie LanzingerAims:
This study aimed to investigate the associations between glycemic outcomes and a range of clinical and demographic factors, including treatment modality, sex, age, diabetes duration, and body mass index, in youth with type 1 diabetes in an international registry.
Methods:
This observational, cross-sectional cohort study included youth <21 years from 23 countries. Proportions of individuals using different treatment modalities (continuous glucose monitoring [CGM] with injections, CGM with pump, automated insulin delivery [AID]) and achieving recommended time in tight range (TITR >50%), time in range (TIR >70%), and glycated hemoglobin (HbA1c) (≤6.5% [48 mmol/mol] and ≤7% [53 mmol/mol]) were assessed using mixed-effects fractional logistic and linear regression models. Sex, age (categorized), diabetes duration (categorized), body mass index standard deviation score (categorized), and treatment modality were included as covariates.
Results:
Data of 7691 individuals (mean [standard deviation] age of 13.7 [4.3] years, diabetes duration 6.3 [4.2] years, 47.8% female) were included. AID users were the most likely to achieve TITR target (adjusted mean [standard error of the mean] 41.2% [2.9]), followed by CGM with insulin pump (25.2% [2.3]) and CGM with injections (13.7% [1.5],
Conclusions:
Children younger than 6 years and individuals not using glucose-responsive insulin therapy were less likely to meet the recommended glycemic targets. It is imperative to minimize these disadvantages.