title: Teenagers with poor metabolic control already have a higher risk of microvascular complications as young adults.
abstract: OBJECTIVE
  To evaluate how HbA1c in adolescents with type 1 diabetes affects microvascular complications in young adults.
  
  
  METHODS
  All individuals registered in the Swedish paediatric diabetes quality registry (SWEDIABKIDS) 13-18 years of age, and as adults registered in the Swedish National Diabetes Registry (NDR) in both the years 2011 and 2012 were included, in total 4250 individuals.
  
  
  RESULTS
  Of the individuals with mean HbA1c >78 mmol/mol in SWEDIABKIDS 83.4% had retinopathy, 15.8% had microalbuminuria and 4.9% had macroalbuminuria in NDR. The logistic regression analysis showed that the OR to develop macroalbuminuria as a young adult was significantly higher in the group with mean HbA1c >78 mmol/mol in SWEDIABKIDS (p<0.05). Among the patients with mean HbA1c above 78 mmol/mol in both registries there was a significantly higher proportion that had retinopathy, microalbuminuria (p<0.001) and/or macroalbuminuria (p<0.01) compared to the group with HbA1c below 57 mmol/mol in both registries. Only 6.5% of the persons in this study were over 30 years of age.
  
  
  CONCLUSIONS
  Paediatric diabetes teams working with teenagers must be aware of the impact of good metabolic control during adolescence, and should intensify the care during this vulnerable period of life to reduce the risk of microvascular complications in young adults.
authors.affiliation: Department of Paediatrics, Ryhov County Hospital, Jönköping Sweden. Electronic address: johan.anderzen@rjl.se.
authors.forename: Johan
authors.initials: J
authors.lastname: Anderzén
authors.affiliation: Department of Clinical and Experimental Medicine, Division of Paediatrics and Diabetes. Research Centre, Linköping University Hospital, Linköping, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Samuelsson
authors.affiliation: Department of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Soffia
authors.initials: S
authors.lastname: Gudbjörnsdottir
authors.affiliation: Department of Medical and Health Sciences, Division of Nursing, Linköping University, Linköping, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Hanberger
authors.affiliation: Department of Paediatrics, Ryhov County Hospital, Jönköping Sweden; Futurum, Jönköping County Council and Jönköping Academy for improvement of health and welfare.
authors.forename: Karin
authors.initials: K
authors.lastname: Åkesson
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000097:blood* / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: Metabolic control; Microvasular complications; National quality register; Teenagers; Type 1 diabetes