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SHR Neuro Cancer Cardio Lipid Metab Microb

Bohn, B; Karges, B; Vogel, C; Otto, KP; Marg, W; Hofer, SE; Fröhlich-Reiterer, E; Holder, M; Plamper, M; Wabitsch, M; Kerner, W; Holl, RW; DPV Initiative.
20 Years of Pediatric Benchmarking in Germany and Austria: Age-Dependent Analysis of Longitudinal Follow-Up in 63,967 Children and Adolescents with Type 1 Diabetes.
PLoS One. 2016; 11(8):e0160971-e0160971 Doi: 10.1371/journal.pone.0160971 [OPEN ACCESS]
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Co-authors Med Uni Graz: Fröhlich-Reiterer Elke
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Abstract:: To investigate changes in diabetes treatment over the last two decades in three age-groups of children and adolescents with type 1 diabetes (T1D) from Germany and Austria. 63,967 subjects (<18yr) with T1D documented between 1995 and 2014 from the DPV-database were included and stratified according to age (0.5-<6, 6-<12, 12-<18yr). Regression models were applied for insulin regimens (<3 and ≥4 injection time points/day, or continuous subcutaneous insulin infusion (CSII)), use of rapid- and long acting insulin analogues, NPH insulin, and frequency of self-monitoring of blood glucose (SMBG)/day. Models were adjusted for sex, diabetes duration, and migration background. P-value for trend was given. The number of subjects with <3 injection time points/day decreased from 1995 to 2014 to <5% in all age-groups (p<0.0001). Proportion of patients with ≥4 injections/day increased until the early 2000s, and then declined until 2014. This trend was not found in 6-<12yr olds (p = 0.3403). CSII increased in all age-groups (p<0.0001) with the highest increase in children <6 years (from 0.4% to 79.2%), and the lowest increase in 12-<18 year olds (from 1.0% to 38.9%). NPH insulin decreased in all age-groups (p<0.0001). Insulin analogues, especially rapid-acting, became more frequent in all age-groups (p<0.0001), accounting for 78.4% in 2014 for all subjects. The highest use was found in the youngest children (in 2014: 85.6%), the lowest use in 6-<12 year olds (in 2014: 72.9%). The number of SMBG/day increased from 2.2 to 6.4 with a similar rise in all age-groups (p<0.0001). Frequency was highest in subjects <6yr. In all age-groups, T1D treatment was intensified over the last 20 years. Age-specific differences in trends were particularly observed in the number of patients on CSII, in the number of patients with 4 or more injections/day, and in the frequency of SMBG/day.
Find related publications in this database (using NLM MeSH Indexing): Adolescent -; Age Factors -; Austria -; Benchmarking -; Blood Glucose - metabolism; Blood Glucose Self-Monitoring -; Child -; Child, Preschool -; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - drug therapy; Drug Administration Schedule -; Female -; Follow-Up Studies -; Germany -; Humans -; Hypoglycemic Agents - administration & dosage; Infant -; Insulin - administration & dosage; Insulin - analogs & derivatives; Insulin Infusion Systems - trends; Insulin, Long-Acting - administration & dosage; Longitudinal Studies -; Male -