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Diabetes Care, Vol 20, Issue 5 714-720, Copyright © 1997 by American Diabetes Association
Comparison of metabolic control in a cross-sectional study of 2,873 children and adolescents with IDDM from 18 countries. The Hvidore Study Group on Childhood Diabetes
HB Mortensen and P Hougaard
Department of Pediatrics, Glostrup University Hospital, Denmark.
OBJECTIVE: To obtain an estimate of the current level of metabolic control
in children and adolescents with IDDM, the Hvidore Study Group on Childhood
Diabetes decided to establish a formal collaboration among countries to
gather and exchange data for comparative purposes. RESEARCH DESIGN AND
METHODS: This cross-sectional non-population-based survey involved 22
pediatric departments from 18 countries in Europe, Japan, and North
America. Blood samples and information were collected from March through
August 1995 on 2,873 children who were born in 1977 or later and seen in
the outpatient clinics. HbA1c levels were determined once and analyzed
centrally (normal range, 4.4-6.3%; mean, 5.4%). Year of birth, sex,
duration of diabetes, height, body weight, insulin regimen, and number of
episodes of severe hypoglycemia during the past 3 months were recorded.
RESULTS: Average HbA1c was 8.6 +/- 1.7%, but varied significantly (P <
0.0001) between centers. Hypoglycemia resulting in unconsciousness and/or
seizures was related to younger age (0-8 years) and lower HbA1c level. The
incidence, based on the 3-month period, was 22 per 100 patient-years. Sixty
percent of the children (n = 1,707) had two injections daily, while 37% (n
= 1,071) were on three or more. HbA1c increased during maturation for both
sexes. No difference in glycemic control was found among adolescents
treated with two, three, and four or more daily injections. Adolescents on
four or more injections received significantly (P < 0.001) more insulin.
Girls on four or more injections had significantly (P < 0.01) higher BMI
than girls on twice-daily insulin. CONCLUSIONS: In the participating
centers with a multidisciplinary team, only one third of the patients had
an HbA1c level of < 8%.

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Copyright © 1997 by the American Diabetes Association.
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