Most people with type 1 diabetes aren’t meeting blood glucose targets, but glucose control varies widely by age and country, according to a new analysis of 22 countries and jurisdictions published in the journal Diabetic Medicine.
The study looked at data from 520,392 people with type 1 diabetes — 54,158 children under 15 years old, 83,065 adolescents and young adults ages 15 to 24, and 382,907 adults ages 25 and older — and covered the years 2016 through 2020. The researchers were interested in comparing A1C levels (a measure of long-term blood glucose control) in different age groups across the 22 countries, as well as looking at how A1C levels have changed over time. Data came mostly from population-based registries, although for five countries it came from clinic-based sources. The countries and jurisdictions included in the study were Austria, Australia, Belgium, Canada, Denmark, England, Finland, France, Germany, Greece, Hong Kong, Ireland, Italy, Latvia, the Netherlands, New Zealand, Norway, Scotland, Slovenia, Sweden, Ukraine, and Wales, as noted in a Healio article on the study.
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Wide range of average A1c by age, other factors
When data was broken down by age group in each geographical area of the study, a wide range of average A1C levels was evident — ranging from 7.2% to 9.5%. The researchers were especially interested in looking at how many people in each age group and geographical region had an A1C level of 7.5% or lower, which is a widely accepted target for adequate blood glucose control — although many recommendations worldwide suggest aiming for 7.0% or lower if possible. After adjusting for the age and sex of participants, the researchers found that people included in clinic-based data were 24% more likely to have an A1C level of 7.5% or lower than all other participants — possibly an indication that clinic-based sources reflect people getting better diabetes care than the general population. Women were 9% less likely than men to meet the 7.5% target, and children under age 15 were 42% more likely to meet that target than adults ages 25 and older. Adolescents and young adults ages 15 to 24 were least likely to meet the 7.5% target — 23% less likely than adults ages 25 and older.
Overall, the researchers found that the proportion of people with an A1C level of 7.5% or lower increased over the course of the study, while the proportion with an A1c level of 9.0% or higher decreased. But most people still fell short of this target. “While some improvement over time has been observed, glycemic control remains sub-optimal for most people with Type 1 diabetes,” the researchers wrote. “Further research is required to better understand whether apparent differences between health systems may relate to such influences as societal factors, structure and delivery of clinical care, and resource allocation,” which “could help inform development of cost-effective interventions to improve outcomes.”
Want to learn more about blood glucose management? See our “Blood Sugar Chart,” then read “Blood Sugar Monitoring: When to Check and Why” and “Strike the Spike II: How to Manage High Blood Glucose After Meals.”