Aims: The TEENs study is an international, cross-sectional observational study aiming to assess type 1 diabetes (T1D) management and psychosocial parameters in children, adolescents, and young adults, to identify approaches to optimise glycaemic control and outcomes. Results from 11 European countries are presented.
Methods: 111 centres providing diabetes care to young T1D patients collected data by participant interview, medical record review and participant/parent surveys from 2943 European youths (47.9% female) in three age groups: children (812 years old (y/o), n=887), adolescents (1318 y/o, n=1451), and young adults (1925 y/o, n=605). A1c was measured uniformly using A1c now (Bayer) (reference range 46%); target A1c defined as <7.5% for ≤18 y/o (ISPAD) and <7% for 1925 y/o (ADA).
Results: Median T1D duration was 6.5 years (interquartile range 3.79.9). Most participants (66.1%) received basal-bolus insulin therapy. Overall, mean A1c was 8.1±1.6% (65.0±17.5 mmol/mol), and varied by age: 7.9±1.4% (62.8±15.3 mmol/mol) in 812 y/o, 8.2±1.7% (66.1±18.6 mmol/mol) in 1318 y/o, and 7.9±1.5% (62.8±16.4 mmol/mol) in 1925 y/o. One-third of participants (1015 (34.5%)) achieved A1c targets (39.4% in 812 y/o, 36.5% in 1318 y/o and 22.6% in 1925 y/o). In the 3 months prior to the study, 72 (3.7%) of those not at A1c target and 20 (2.0%) of those at target had ≥1 diabetic ketoacidosis (DKA) episode, while 22 (1.1%) and 14 (1.4%), respectively, had ≥1 severe hypoglycaemic event (leading to seizure or loss of consciousness). Overall, occurrence of DKA was higher in children and adolescents (3.3% in both age groups) than young adults (2.5%), and severe hypoglycaemic events occurred in 1.5, 1.0, and 1.5% of 812, 1318, and 1925 y/o respectively.
Conclusions: Overall, in European youths, diabetes outcomes remain sub-optimal, with mean A1c above target for two-thirds of participants and many youth experiencing acute complications, supporting the need for further improvements.
Study sponsored by Sanofi.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology