Persistent individual tracking within overall improvement in HbA1c in a UK paediatric diabetes clinic over 15 years.
BACKGROUND
There is some evidence of long-term tracking of HbA(1c) levels within diabetes centres, but little evidence of individual tracking.


METHODS
HbA(1c) levels of children in the clinic over a period of 15 years were retrieved from the clinical chemistry laboratory information system. We measured the correlation of HbA(1c) between years (Spearman and Pearson rank correlation), as well as the relationship of HbA(1c) with age and the change over time in the clinic.


RESULTS
Data were collected from 362 children and young people [158 female (44%)], aged 0-18 years (median 10.4 years), with 0-13.6 years of follow-up (median 4.7 years). Mean HbA(1c) levels fell from 9.3 ± 1.5% (78 ± 16 mmol/mol) in 2001 to 8.1 ± 1.3% (65 ± 14 mmol/mol) in 2009 in those at least 6 months after diagnosis (P<0.0001). HbA(1c) levels gradually rise with increasing age. HbA(1c) levels from year to year are significantly correlated. This is better for adjacent than subsequent years, but there is a significant correlation up to 9 years from diagnosis. Only 4 of 49 children with a 6-month HbA(1c) level of 9% (75 mmol/mol) or more had a long-term (2-5 years) median HbA(1c) <8% (64 mmol/mol).


CONCLUSIONS
HbA(1c) levels track in individuals within an improvement in overall clinic levels, suggesting that, if optimal control can be achieved in the first 6 months, it can persist for up to 9 years.
Edge
J A
JA
Department of Paediatric Endocrinology and Diabetes, Oxford Children's Hospital Department of Biochemistry, John Radcliffe Hospital, Oxford, UK.
James
T
T
Shine
B
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D000293:Adolescent; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000187:drug effects* / Q000378:metabolism; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies
D001786:Blood Glucose; D006442:Glycated Hemoglobin