Stable Metabolic Control but Increased Demand for Professional Support in Children with Type 1 Diabetes in the Past Ten Years in Bern/Switzerland: A Quality Control Study

Introduction. Lower HbA1c targets and increasingly complex diabetes management with substantially increasing costs dominate today’s type 1 diabetes therapy in children and adolescents. Objective. To evaluate metabolic control in children and adolescents with type 1 diabetes and assess associated fac...

Full description

Saved in:
Bibliographic Details
Main Authors: Michelle J. Dennig, Grit Sommer, Tanja Zingg, Christa E. Flück, Claudia Boettcher
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/2022/3170558
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832559403500306432
author Michelle J. Dennig
Grit Sommer
Tanja Zingg
Christa E. Flück
Claudia Boettcher
author_facet Michelle J. Dennig
Grit Sommer
Tanja Zingg
Christa E. Flück
Claudia Boettcher
author_sort Michelle J. Dennig
collection DOAJ
description Introduction. Lower HbA1c targets and increasingly complex diabetes management with substantially increasing costs dominate today’s type 1 diabetes therapy in children and adolescents. Objective. To evaluate metabolic control in children and adolescents with type 1 diabetes and assess associated factors, evaluate determinants for frequency of healthcare contacts, and compare actual with historical data. Method. This cross-sectional observational study collected data on 178 children and adolescents with type 1 diabetes treated at the University Children’s Hospital in Bern. Results. Mean HbA1c was 7.9% (63 mmol/mol), 33.1% (59/178) of children reached the target of HbA1c<7.5% (<59 mmol/mol), and 18.0% (32/178) had an HbA1c value<7.0% (<53 mmol/mol). Compared to historical data, stable HbA1c levels appeared with a doubled proportion of individuals using insulin pumps. Metabolic control was worse with a longer duration of diabetes and younger age at diagnosis but better when parents came from a Western European country. Age at the consultation, use of diabetes technology and native language influenced the number of healthcare contacts. Younger patients, patients using CSII, and patients without an official Swiss language as mother tongue had more consultations with a healthcare professional than older and native language individuals. Conclusion. The metabolic targets in childhood and adolescent type 1 diabetes are still unmet despite a shift towards more technology. Our study documents a higher demand for support and supervision in specific patient groups. An investment to increase healthcare contacts could help combat the increase in total diabetes cost and significantly improve metabolic control.
format Article
id doaj-art-304dce15a1544449b539e75a055cbe44
institution Kabale University
issn 2314-6753
language English
publishDate 2022-01-01
publisher Wiley
record_format Article
series Journal of Diabetes Research
spelling doaj-art-304dce15a1544449b539e75a055cbe442025-02-03T01:30:01ZengWileyJournal of Diabetes Research2314-67532022-01-01202210.1155/2022/3170558Stable Metabolic Control but Increased Demand for Professional Support in Children with Type 1 Diabetes in the Past Ten Years in Bern/Switzerland: A Quality Control StudyMichelle J. Dennig0Grit Sommer1Tanja Zingg2Christa E. Flück3Claudia Boettcher4Department of Paediatric EndocrinologyDepartment of Paediatric EndocrinologyDepartment of Paediatric EndocrinologyDepartment of Paediatric EndocrinologyDepartment of Paediatric EndocrinologyIntroduction. Lower HbA1c targets and increasingly complex diabetes management with substantially increasing costs dominate today’s type 1 diabetes therapy in children and adolescents. Objective. To evaluate metabolic control in children and adolescents with type 1 diabetes and assess associated factors, evaluate determinants for frequency of healthcare contacts, and compare actual with historical data. Method. This cross-sectional observational study collected data on 178 children and adolescents with type 1 diabetes treated at the University Children’s Hospital in Bern. Results. Mean HbA1c was 7.9% (63 mmol/mol), 33.1% (59/178) of children reached the target of HbA1c<7.5% (<59 mmol/mol), and 18.0% (32/178) had an HbA1c value<7.0% (<53 mmol/mol). Compared to historical data, stable HbA1c levels appeared with a doubled proportion of individuals using insulin pumps. Metabolic control was worse with a longer duration of diabetes and younger age at diagnosis but better when parents came from a Western European country. Age at the consultation, use of diabetes technology and native language influenced the number of healthcare contacts. Younger patients, patients using CSII, and patients without an official Swiss language as mother tongue had more consultations with a healthcare professional than older and native language individuals. Conclusion. The metabolic targets in childhood and adolescent type 1 diabetes are still unmet despite a shift towards more technology. Our study documents a higher demand for support and supervision in specific patient groups. An investment to increase healthcare contacts could help combat the increase in total diabetes cost and significantly improve metabolic control.http://dx.doi.org/10.1155/2022/3170558
spellingShingle Michelle J. Dennig
Grit Sommer
Tanja Zingg
Christa E. Flück
Claudia Boettcher
Stable Metabolic Control but Increased Demand for Professional Support in Children with Type 1 Diabetes in the Past Ten Years in Bern/Switzerland: A Quality Control Study
Journal of Diabetes Research
title Stable Metabolic Control but Increased Demand for Professional Support in Children with Type 1 Diabetes in the Past Ten Years in Bern/Switzerland: A Quality Control Study
title_full Stable Metabolic Control but Increased Demand for Professional Support in Children with Type 1 Diabetes in the Past Ten Years in Bern/Switzerland: A Quality Control Study
title_fullStr Stable Metabolic Control but Increased Demand for Professional Support in Children with Type 1 Diabetes in the Past Ten Years in Bern/Switzerland: A Quality Control Study
title_full_unstemmed Stable Metabolic Control but Increased Demand for Professional Support in Children with Type 1 Diabetes in the Past Ten Years in Bern/Switzerland: A Quality Control Study
title_short Stable Metabolic Control but Increased Demand for Professional Support in Children with Type 1 Diabetes in the Past Ten Years in Bern/Switzerland: A Quality Control Study
title_sort stable metabolic control but increased demand for professional support in children with type 1 diabetes in the past ten years in bern switzerland a quality control study
url http://dx.doi.org/10.1155/2022/3170558
work_keys_str_mv AT michellejdennig stablemetaboliccontrolbutincreaseddemandforprofessionalsupportinchildrenwithtype1diabetesinthepasttenyearsinbernswitzerlandaqualitycontrolstudy
AT gritsommer stablemetaboliccontrolbutincreaseddemandforprofessionalsupportinchildrenwithtype1diabetesinthepasttenyearsinbernswitzerlandaqualitycontrolstudy
AT tanjazingg stablemetaboliccontrolbutincreaseddemandforprofessionalsupportinchildrenwithtype1diabetesinthepasttenyearsinbernswitzerlandaqualitycontrolstudy
AT christaefluck stablemetaboliccontrolbutincreaseddemandforprofessionalsupportinchildrenwithtype1diabetesinthepasttenyearsinbernswitzerlandaqualitycontrolstudy
AT claudiaboettcher stablemetaboliccontrolbutincreaseddemandforprofessionalsupportinchildrenwithtype1diabetesinthepasttenyearsinbernswitzerlandaqualitycontrolstudy