ESPE2014 Poster Presentations Diabetes (11 abstracts)
Glycaemic Control and Acute Complications in European Children, Adolescents, and Young Adults With Type 1 Diabetes in the Teens Study
Moshe Phillip a , Lori Laffel b , Catherine Domenger c , Marie-Paule Dain c , Valerie Pilorget d , Christophe Candelas d , Thomas Danne e , Carmen Mazza f , Barbara Anderson g , Ragnar Hanas h , Sheridan Waldron i , Roy Beck j & Chantal Mathieu k
aInstitute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel; bPediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Boston, Massachusetts, USA; cSanofi, Paris, France; dSanofi, Chilly Mazarin, France; eKinder und Jugendkrankenhaus ‘Auf der Bult’, Hannover, Germany; fNutrition Department, Hospital de Pediatría J P Garrahan, Buenos Aires, Argentina; gSection of Psychology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA; hNU Hospital Group, Department of Pediatrics, Uddevalla and Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; iHosted by West Midlands Strategic Clinical Network, Birmingham, UK; jJaeb Center for Health Research, Tampa, Florida, USA; kUniversity Hospitals (UZ), Leuven, Belgium
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 (8–12 years old (y/o), n=887), adolescents (13–18 y/o, n=1451), and young adults (19–25 y/o, n=605). A1c was measured uniformly using A1c now (Bayer) (reference range 4–6%); target A1c defined as <7.5% for ≤18 y/o (ISPAD) and <7% for 19–25 y/o (ADA).
Results: Median T1D duration was 6.5 years (interquartile range 3.7–9.9). 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 8–12 y/o, 8.2±1.7% (66.1±18.6 mmol/mol) in 13–18 y/o, and 7.9±1.5% (62.8±16.4 mmol/mol) in 19–25 y/o. One-third of participants (1015 (34.5%)) achieved A1c targets (39.4% in 8–12 y/o, 36.5% in 13–18 y/o and 22.6% in 19–25 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 8–12, 13–18, and 19–25 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.
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