The Stricter the Better? The Relationship between Targeted HbA1c Values and Metabolic Control of Pediatric Type 1 Diabetes Mellitus. (5th January 2016)

• Record Type: Journal Article
• Authors: Braun, Marcin; Tomasik, Bartlomiej; Wrona, Ewa; Fendler, Wojciech; Jarosz-Chobot, Przemyslawa; Szadkowska, Agnieszka; Zmysłowska, Agnieszka; Wilson, Jayne; Mlynarski, Wojciech
• Other Names: Ruperez Francisco J. Academic Editor.
• Is Part Of: Journal of diabetes research. Volume 2016(2016)
• Publication Date: 2016-01-05
• Subjects: Diabetes -- Periodicals; Diabetes -- Pathophysiology -- Periodicals; Diabetes -- Prevention -- Periodicals; Diabetes -- Etiology -- Periodicals; Diabetes -- Epidemiology -- Periodicals; Diabetes -- Pathogenesis -- Periodicals; 616.462005
• DOI: 10.1155/2016/5490258
• Languages: English
• ISSNs: 2314-6745

Abstract

Abstract : Introduction . It remains unclear howH b A 1 c recommendations influence metabolic control of paediatric patients with type 1 diabetes mellitus. To evaluate this we compared reportedH b A 1 c with guideline thresholds. Materials and Methods . We searched systematically MEDLINE and EMBASE for studies reporting onH b A 1 c in children with T1DM and grouped them according to targetedH b A 1 c obtained from regional guidelines. We assessed the discrepancies in the metabolic control between these groups by comparing meanH b A 1 c extracted from each study and the differences between actual and targetedH b A 1 c . Results . We included 105 from 1365 searched studies. The median (IQR)H b A 1 c for the study population was 8.30% (8.00%–8.70%) and was lower in "6.5%" than in "7.5%" as targetedH b A 1 c level (8.20% (7.85%–8.57%) versus 8.40% (8.20%–8.80%);p = 0.028 ). Median difference between actual and targetedH b A 1 c was 1.20% (0.80%–1.70%) and was higher in "6.5%" than in "7.5%" (1.70% (1.30%–2.07%) versus 0.90% (0.70%–1.30%), resp.;p < 0.001 ). Conclusions . Our study indicates that the 7.5% threshold results inH b A 1 c levels being closer to the therapeutic goal, but the actual values are still higher than those observed in the "6.5%" group. A meta-analysis of raw data from national registries or a prospective study comparing both approaches is warranted as the next step to examine this subject further.