Department of Epidemiology, Institute of Applied Economics and Health Research, Copenhagen, Denmark.
Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, Ulm, Germany.
Diabetes Technol Ther. 2021 Jul;23(7):491-499. doi: 10.1089/dia.2020.0618. Epub 2021 Feb 26.
The international SWEET registry (NCT04427189) was initiated in 2008 to improve outcomes in pediatric diabetes. A 10-year follow-up allowed studying time trends of key quality indicators in 22 centers from Europe, Australia, Canada, and India in youth with type 1 diabetes (T1D). Aggregated data per person with T1D <25 years of age were compared between 2008-2010 and 2016-2018. Hierarchic linear and logistic regression models were applied. Models were adjusted for gender, age-, and diabetes duration groups. The first and second time periods included 4930 versus 13,654 persons, 51% versus 52% male, median age 11.3 [Q1; Q3: 7.9; 14.5] versus 13.3 [9.7; 16.4] years, and T1D duration 2.9 [0.8; 6.4] versus 4.2 [1.4; 7.7] years. The adjusted hemoglobin A1C (HbA1c) improved from 68 (95% confidence interval [CI]: 66-70) to 63 (60; 65) mmol/mol ( < 0.0001) or 8.4 (95% CI: 8.2-8.6) to 7.9 (7.6; 8.1) % ( < 0.0001). Across all age groups, HbA1c was significantly lower in pump and sensor users. Severe hypoglycemia declined from 3.8% (2.9; 5.0) to 2.4% (1.9; 3.1) ( < 0.0001), whereas diabetic ketoacidosis events increased significantly with injection therapy only. Body mass index-standard deviation score also showed significant improvements 0.55 (0.46; 0.64) versus 0.42 (0.33; 0.51) ( < 0.0001). Over time, the increase in pump use from 34% to 44% preceded the increase in HbA1c target achievement (<53 mmol/mol) from 21% to 34%. Twice yearly benchmarking within the SWEET registry was associated with significantly improved HbA1c on a background of increasing pump and sensor use for 10 years in young persons with T1D. NCT04427189.
国际 SWEET 登记处（NCT04427189）于 2008 年成立，旨在改善儿科糖尿病的治疗结果。10 年的随访使我们能够研究欧洲、澳大利亚、加拿大和印度的 22 个中心中，1 型糖尿病（T1D）青少年的关键质量指标的时间趋势。对年龄＜25 岁的每位 T1D 患者的汇总数据进行比较，比较对象为 2008-2010 年和 2016-2018 年。应用了层次线性和逻辑回归模型。模型根据性别、年龄和糖尿病持续时间组进行了调整。第一和第二时间段分别纳入了 4930 人和 13654 人，其中男性分别占 51%和 52%，中位年龄分别为 11.3 [Q1；Q3：7.9；14.5]和 13.3 [9.7；16.4]岁，T1D 持续时间分别为 2.9 [0.8；6.4]和 4.2 [1.4；7.7]年。调整后的血红蛋白 A1c（HbA1c）从 68（95%置信区间[CI]：66-70）mmol/mol 改善至 63（60；65）mmol/mol（<0.0001）或从 8.4（95%CI：8.2-8.6）%改善至 7.9（7.6；8.1）%（<0.0001）。在所有年龄组中，使用胰岛素泵和传感器的患者的 HbA1c 显著降低。严重低血糖事件从 3.8%（2.9；5.0）下降至 2.4%（1.9；3.1）（<0.0001），而仅接受注射治疗的患者中糖尿病酮症酸中毒事件显著增加。体重指数标准差评分也有显著改善，从 0.55（0.46；0.64）改善至 0.42（0.33；0.51）（<0.0001）。随着时间的推移，胰岛素泵使用从 34%增加至 44%，早于 HbA1c 目标达标率（<53mmol/mol）从 21%增加至 34%。在 SWEET 登记处，每年进行两次基准测试，在此背景下，使用胰岛素泵和传感器的患者比例在 10 年内增加，1 型糖尿病患者的 HbA1c 得到了显著改善。NCT04427189。
