title: Longitudinal Trajectories of Metabolic Control From Childhood to Young Adulthood in Type 1 Diabetes From a Large German/Austrian Registry: A Group-Based Modeling Approach.
abstract: Worsening of glycemic control in type 1 diabetes during puberty is a common observation. However, HbA1cremains stable or even improves for some youths. The aim is to identify distinct patterns of glycemic control in type 1 diabetes from childhood to young adulthood.
  
  
  
  A total of 6,433 patients with type 1 diabetes were selected from the prospective, multicenter diabetes patient registry Diabetes-Patienten-Verlaufsdokumentation (DPV) (follow-up from age 8 to 19 years, baseline diabetes duration ≥2 years, HbA1caggregated per year of life). We used latent class growth modeling as the trajectory approach to determine distinct subgroups following a similar trajectory for HbA1cover time.
  
  
  
  Five distinct longitudinal trajectories of HbA1cwere determined, comprising group 1 = 40%, group 2 = 27%, group 3 = 15%, group 4 = 13%, and group 5 = 5% of patients. Groups 1-3 indicated stable glycemic control at different HbA1clevels. At baseline, similar HbA1cwas observed in group 1 and group 4, but HbA1cdeteriorated in group 4 from age 8 to 19 years. Similar patterns were present in group 3 and group 5. We observed differences in self-monitoring of blood glucose, insulin therapy, daily insulin dose, physical activity, BMI SD score, body-height SD score, and migration background across all HbA1ctrajectories (allP≤ 0.001). No sex differences were present. Comparing groups with similar initial HbA1cbut different patterns, groups with higher HbA1cincrease were characterized by lower frequency of self-monitoring of blood glucose and physical activity and reduced height (allP< 0.01).
  
  
  
  Using a trajectory approach, we determined five distinct longitudinal patterns of glycemic control from childhood to early adulthood. Diabetes self-care, treatment differences, and demographics were related to different HbA1ccourses.
authors.affiliation: Institute of Epidemiology and Medical Biometry (ZIBMT), University of Ulm, Ulm, Germany anke.schwandt@uni-ulm.de.|German Center for Diabetes Research (DZD), Neuherberg, Germany.
authors.forename: Anke
authors.initials: A
authors.lastname: Schwandt
authors.affiliation: Institute of Epidemiology and Medical Biometry (ZIBMT), University of Ulm, Ulm, Germany.|German Center for Diabetes Research (DZD), Neuherberg, Germany.
authors.forename: Julia M
authors.initials: JM
authors.lastname: Hermann
authors.affiliation: German Center for Diabetes Research (DZD), Neuherberg, Germany.|Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Rosenbauer
authors.affiliation: Division of Pediatric Endocrinology and Diabetology, Centre of Child and Adolescent Medicine, Justus Liebig University, Giessen, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Boettcher
authors.affiliation: Department of Pediatrics, Clinical Center Augsburg, Augsburg, Germany.
authors.forename: Désirée
authors.initials: D
authors.lastname: Dunstheimer
authors.affiliation: Department of Pediatrics, University of Heidelberg, Heidelberg, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Grulich-Henn
authors.affiliation: German Center for Diabetes Research (DZD), Neuherberg, Germany.|Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Kuss
authors.affiliation: Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Birgit
authors.initials: B
authors.lastname: Rami-Merhar
authors.affiliation: Department of Pediatrics, Children's Hospital Chemnitz, Chemnitz, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Vogel
authors.affiliation: Institute of Epidemiology and Medical Biometry (ZIBMT), University of Ulm, Ulm, Germany.|German Center for Diabetes Research (DZD), Neuherberg, Germany.
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D001317:Austria; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D005260:Female; D005858:Germany; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D011446:Prospective Studies; D012042:Registries; D044465:White People; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin