Improvement of Care & Outcome


McKnight JA, Wild SH, Lamb MJ, Cooper MN, Jones TW, Davis EA, Hofer S et al.

Glycaemic control of type 1 diabetes in clinical practice early in the 21st century: an international comparison. Diabet Med. 2015;32:1036-50.

How do outcomes measures for T1DM vary from country to country? This study used HbA1c data from population and clinic-based registries to see what levels of glycaemic control are being achieved, stratified by age and sex.


Overall, the researchers obtained HbA1c data on 324,501 patients with T1DM, from the following countries: Australia, Austria, Denmark, England, France, Germany, Greece, Italy, Latvia, The Netherlands (data provided by Diabeter), New Zealand, Northern Ireland, Norway, Republic of Ireland, Scotland, Sweden, Ukraine, USA, and Wales.


Key findings:

  • Overall, among T1DM patients aged younger than 15 years, the proportion with HbA1c below 7.5% (signifying good glycemic control) ranged from 15.7% to 46.4%.
  • Among patients aged 15-25 years, the proportion with HbA1c below 7.5% ranged from 8.9% to 49.5%.
  • Among patients aged 25 years or older, the proportion with HbA1c below 7.5% ranged from 20.5% to 53.6%.
  • Only minor sex differences were observed. Overall, 29% of men and 27% of women achieved an HbA1c level below 7.5%.
  • Data on use of insulin pumps were available from 12 of the registry sources, and showed wide variation between registries.


Discussing their findings, the researchers said “it is clear that there is scope for improvement in the glycaemic control of type 1 diabetes in all countries”. They said a next step could be to investigate whether identifying the reasons for between-country differences in HbA1c levels could help improve future outcomes.


For PubMed abstract click here

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