A1C in children and adolescents with diabetes in relation to certain clinical parameters

Objective: We explored the relation between A1C and insulin regimen, duration of diabetes, age, gender, BMI, and the differences between clinical mean A1C at pediatric diabetes clinics in Sweden. Research Design and Methods: Data, registered in a national quality registry, the Swedish Childhood Diabetes Registry (SWEDIABKIDS) from 18,651 clinical outpatient visits (1,033 girls, 1,147 boys) at 20 pediatric clinics during 2001 and 2002 were analyzed. Results: A1C was <7.0 %(our target value, approximately 8% DCCT/NGSP value) at 35% of the visits. Girls had significantly higher mean A1C than boys during adolescence. High mean A1C correlated with high mean insulin dose, long duration and high age. Center mean A1C varied between clinics (6.8-8.2%). Center differences could not be explained by differences in diabetes duration, age, BMI or insulin dose. Conclusions: Adolescents with high insulin dose and long duration, especially girls need to be focused on. Center differences remained inexplicable and require further investigation.