Treatment regimens and glycaemic outcomes in more than 100 000 children with type 1 diabetes (2013–22): a longitudinal analysis of data from paediatric diabetes registries
An erratum to this article was published (Lancet Diabetes Endocrinol, Apr 2025 ↗)
Authors' conclusion
Between 2013 and 2022, glycaemic outcomes have improved, parallel to increased use of diabetes technology. Many children had HbA1c higher than the International Society for Pediatric and Adolescent Diabetes (ISPAD) 2022 target. Reassuringly, despite targeting lower HbA1c, severe hypoglycaemia event rates are decreasing. Even for children with type 1 diabetes who have access to specialised diabetes care and diabetes technology, further advances in diabetes management are required to assist with achieving ISPAD glycaemic targets.
Study context
- Population
- Children (aged ≤18 years) with T1D of duration >3 months in eight national and one international (SWEET) paediatric diabetes registries, 2013–20222,022
- Participants
- 109,494 children
- Exposure
- 2022 vs 2013
- 2022n = 109,494
- Outcome
- HbA1c (aggregated mean)
- Follow-up
- 2013 to 2022
Methodological detailsmultinational, eight national and one international registries, pre-defined analyses conducted separately by each registry, joinpoint regression
- Multinational
- Eight national and one international registries
- Pre-defined analyses conducted separately by each registry
- Joinpoint regression
Main finding
As reported in the abstract
| Group | Value | Mmol/mol |
|---|---|---|
| 2013 | mean 8.2 (CI 8.1–8.3) % | 66.5 [65.2-67.7] |
| 2022 | mean 7.6 (CI 7.5–7.7) % | 59.4 [58.2-60.5] |
Value
Mmol/mol
Observational data: associations, not effects.
Further findings
HbA1c <7% (<53 mmol/mol) · 2013 to 2022
P < 0.0001
| Outcome | 2013 | 2022 | Mean difference (%) (CI) | P value | |
|---|---|---|---|---|---|
| Insulin pump use · 2013 to 2022 | 42.9% (95% CI 40.4–45.5) | 60.2% (95% CI 57.9–62.6) | 17.3 (13.8–20.7) | P < 0.0001 | |
| CGM use · 2016 to 20222022vs 2016 | — not stated in the abstract | 81.7% (CI 73.0–90.4) | 63.0 (50.3–75.7) | P < 0.0001 | |
| −50050100Difference, % (linear scale) |
— not stated in the abstract
- Continuous glucose monitoring (CGM) use — CGM use in 2016
- 18.7% (95% CI 9.5-28.0)
Safety
Events per 100 person-years
| Outcome | 2013 | 2022 |
|---|---|---|
| Severe hypoglycaemia (events per 100 person-years) | 3.0 (95% CI 2.0–4.9) | 1.7 (CI 1.0–2.7) |
| DKA (events per 100 person-years) | 3.1 (95% CI 2.0–4.8) | 2.2 (CI 1.4–3.4) |
Original publication
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