title: Tracking of metabolic control from childhood to young adulthood in type 1 diabetes.
abstract: OBJECTIVE
  This prospective longitudinal survey was designed to follow patients with diabetes from disease onset in childhood over an extended period of time including puberty until young adulthood with respect to metabolic control.
  
  
  METHODS
  An electronic diabetes patient documentation system used in diabetes centers in Austria and Germany was utilized for standardized data collection. Complete documentation of metabolic control for prepuberty (≤ 13 years), puberty (14-19 years), and adulthood (≥ 20 years) was available in 1146 patients.
  
  
  RESULTS
  Median age at diabetes manifestation was 7.2 (IQR 4.7-9.4) years; 49% were male. In the prepubertal stage, median glycated hemoglobin A1c (HbA1c) was 7.5 (IQR 6.8-8.3), during puberty 8.0 (IQR 7.3-8.9), and after puberty 7.8 (IQR 7.1-9.0). A significant intra-individual correlation was found for prepuberty to puberty HbA1c levels (R = 0.55, P < .001), puberty to adulthood (R = 0.59, P < .001), as well as prepuberty to adulthood (R = 0.30, P < .001). When patients were divided into tertiles of prepubertal HbA1c, HbA1c increased in all 3 groups over time, however, significant group differences tracked into adulthood (P < .001 at all stages). A regression model identified pre-pubertal HbA1c as a significant and relevant predictor of metabolic control in young adulthood adjusted for confounders (P < .001).
  
  
  CONCLUSIONS
  This survey provides evidence for long-term tracking of metabolic control from childhood until adulthood, suggesting an early focus on metabolic control.
authors.affiliation: Department of Pediatrics 1, Medical University of Innsbruck, Innsbruck, Austria. Electronic address: Sabine.E.Hofer@i-med.ac.at.
authors.forename: Sabine E
authors.initials: SE
authors.lastname: Hofer
authors.affiliation: Department of Pediatrics, Experimental and Clinical Research Center, Charite, Berlin, Germany.
authors.forename: Klemens
authors.initials: K
authors.lastname: Raile
authors.affiliation: Department of Pediatrics, Medical University of Graz, Graz, Austria.
authors.forename: Elke
authors.initials: E
authors.lastname: Fröhlich-Reiterer
authors.affiliation: Department of Pediatrics, University of Leipzig, Leipzig, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kapellen
authors.affiliation: Department of Pediatrics, University of Jena, Jena, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Dost
authors.affiliation: Institute for Biometrics and Epidemiology, German Diabetes Center at Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Rosenbauer
authors.affiliation: Department of Pediatrics, University of Heidelberg, Heidelberg, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Grulich-Henn
authors.affiliation: Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006706:Homeostasis; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012648:Self Care; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human