Abstract
Background: Suboptimal glycaemic control in children and adolescents with type-1-diabetes is prevalent and associated with increased risk of diabetes-related complications. We aimed to identify distinct trajectories of glycated haemoglobin (HbA1c) among Danish children and adolescents diagnosed with type-1-diabetes.
Methods: Data were obtained from the Danish Registry of Childhood and Adolescent Diabetes (DanDiabKids) which comprises all Danish children from 0-18 years diagnosed with type-1-diabetes from 1996-2019. We identified subgroups of distinct trajectories of HbA1c using a data-driven latent class trajectory (LCT) modelling. Children with at least 2 repeated measurements of HbA1c were included in the LCTM modelling.
Results: A total of 5890 children (51% boys) were measured a median of 6 times (IQR 3-8), contributing with 31,368 HbA1c measurements to the analyses. We identified 4 distinct trajectories of HbA1c from 2-18 years of age. We found an acceptable ability of the LCTM modelling to discriminate between the identified classes with high mean probabilities of assigned class membership for all 4 classes. Most children presented a stable HbA1c trajectory ranging from 60-66 mmol/mol (83.4%, turquoise). A small group of children presented a rapidly deteriorating HbA1c trajectory starting from the age of 14 years and ending with an average HbA1c of around 110 mmol/mol (4.9%, red). Two smaller groups presented deteriorating HbA1c trajectories starting from 8 years, with a peak at 14 years (5.1%, purple) and 11.5 years, with a peak at 16 years, respectively, after which both HbA1c trajectories returned to moderately elevated levels.
Conclusions: Applying data-driven modelling, we show that persons with type-1-diabetes experience heterogenous trajectories of glycaemic control throughout childhood and adolescence. Associations of these distinct trajectories with later diabetes-related complications and mortality will be examined in subsequent analyses.
Methods: Data were obtained from the Danish Registry of Childhood and Adolescent Diabetes (DanDiabKids) which comprises all Danish children from 0-18 years diagnosed with type-1-diabetes from 1996-2019. We identified subgroups of distinct trajectories of HbA1c using a data-driven latent class trajectory (LCT) modelling. Children with at least 2 repeated measurements of HbA1c were included in the LCTM modelling.
Results: A total of 5890 children (51% boys) were measured a median of 6 times (IQR 3-8), contributing with 31,368 HbA1c measurements to the analyses. We identified 4 distinct trajectories of HbA1c from 2-18 years of age. We found an acceptable ability of the LCTM modelling to discriminate between the identified classes with high mean probabilities of assigned class membership for all 4 classes. Most children presented a stable HbA1c trajectory ranging from 60-66 mmol/mol (83.4%, turquoise). A small group of children presented a rapidly deteriorating HbA1c trajectory starting from the age of 14 years and ending with an average HbA1c of around 110 mmol/mol (4.9%, red). Two smaller groups presented deteriorating HbA1c trajectories starting from 8 years, with a peak at 14 years (5.1%, purple) and 11.5 years, with a peak at 16 years, respectively, after which both HbA1c trajectories returned to moderately elevated levels.
Conclusions: Applying data-driven modelling, we show that persons with type-1-diabetes experience heterogenous trajectories of glycaemic control throughout childhood and adolescence. Associations of these distinct trajectories with later diabetes-related complications and mortality will be examined in subsequent analyses.
| Originalsprog | Engelsk |
|---|---|
| Publikationsdato | 26 apr. 2021 |
| Status | Udgivet - 26 apr. 2021 |
| Begivenhed | European Diabetes Epidemiology Group, EDEG, 2021 - virtual Varighed: 26 apr. 2021 → 27 apr. 2021 |
Konference
| Konference | European Diabetes Epidemiology Group, EDEG, 2021 |
|---|---|
| Lokation | virtual |
| Periode | 26/04/2021 → 27/04/2021 |