Target setting in intensive insulin management is associated with metabolic control: the Hvidoere Childhood Diabetes Study Group Centre Differences Study 2005 |
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| Authors: | PGF Swift TC Skinner CE De Beaufort FJ Cameron J Åman H‐J Aanstoot L Castaño F Chiarelli D Daneman T Danne H Dorchy H Hoey EA Kaprio F Kaufman M Kocova HB Mortensen PR Njølstad M Phillip KJ Robertson EJ Schoenle T Urakami M Vanelli RW Ackermann SE Skovlund for the Hvidoere Study Group on Childhood Diabetes |
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| Affiliation: | 1. Children's Hospital, Leicester Royal Infirmary, UK;2. Combined Universities Centre for Rural Health, Geraldton, Western Australia;3. Clinique Pédiatrique, Centre Hospitalier de Luxembourg, Luxembourg;4. Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Australia;5. Barn‐och ungdomskliniken, Universitetssjukhuset S?dra Grev Rosengatan, Sweden;6. Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands;7. Endocrinology and Diabetes Research Group, Hospital de Cruces, Ciberdem, Spain;8. Department of Paediatrics, University of Chieti, Chieti, Italy;9. The Hospital for Sick Children, University of Toronto, Canada;10. Kinderkrankenhaus auf der Bult, Hannover, Germany;11. H?pital Universitaire des Enfants Reine Fabiola Diabetology Clinic, Brussels, Belgium;12. Department of Paediatrics, Trinity College, National Children's Hospital, Dublin, Ireland;13. Peijas Hospital, Vantaa, Finland;14. Children's Hospital of Los Angeles, USA;15. Medical Faculty, Department of Endocrinology and Genetics, Pediatric Clinic, Republic of Macedonia;16. Department of Paediatrics, Glostrup University Hospital, Denmark;17. Department of Pediatrics, Haukeland University Hospital, Norway;18. Department of Clinical Medicine, University of Bergen, Norway;19. National Center of Childhood Diabetes, Schneider Children's Medical Center, Petah Tikva, Israel;20. Royal Hospital for Sick Children, Glasgow, Scotland;21. University Childrens Hospital, Zurich, Switzerland;22. Department of Paediatrics, Nihon University School of Medicine, Tokyo, Japan;23. Centro di Diabetologia, University of Parma, Italy;24. and;25. Novo Nordisk A/S, Bagsvaerd, Denmark |
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| Abstract: | ![]()
Swift PGF, Skinner TC, de Beaufort CE, Cameron FJ, Åman J, Aanstoot H‐J, Castaño L, Chiarelli F, Daneman D, Danne T, Dorchy H, Hoey H, Kaprio EA, Kaufman F, Kocova M, Mortensen HB, Njølstad PR, Phillip M, Robertson KJ, Schoenle EJ, Urakami T, Vanelli M, Ackermann RW, Skovlund SE for the Hvidoere Study Group on Childhood Diabetes. Target setting in intensive insulin management is associated with metabolic control: the Hvidoere Childhood Diabetes Study Group Centre Differences Study 2005. Objective: To evaluate glycaemic targets set by diabetes teams, their perception by adolescents and parents, and their influence on metabolic control. Methods: Clinical data and questionnaires were completed by adolescents, parents/carers and diabetes teams in 21 international centres. HbA1c was measured centrally. Results: A total of 2062 adolescents completed questionnaires (age 14.4 ± 2.3 yr; diabetes duration 6.1 ± 3.5 yr). Mean HbA 1c = 8.2 ± 1.4% with significant differences between centres (F = 12.3; p < 0.001) range from 7.4 to 9.1%. There was a significant correlation between parent (r = 0.20) and adolescent (r = 0.21) reports of their perceived ideal HbA1c and their actual HbA1c result (p < 0.001), and a stronger association between parents' (r = 0.39) and adolescents' (r = 0.4) reports of the HbA1c they would be happy with and their actual HbA1c result. There were significant differences between centres on parent and adolescent reports of ideal and happy with HbA1c (8.1 < F > 17.4;p < 0.001). A lower target HbA1c and greater consistency between members of teams within centres were associated with lower centre HbA1c (F = 16.0; df = 15; p < 0.001). Conclusions: Clear and consistent setting of glycaemic targets by diabetes teams is strongly associated with HbA1c outcome in adolescents. Target setting appears to play a significant role in explaining the differences in metabolic outcomes between centres. |
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| Keywords: | adolescence centre differences glycaemic control targets |
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