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The Australasian Diabetes Data Network: first national audit of children and adolescents with type 1 diabetes

Helen Phelan, Helen Clapin, Loren Bruns, Fergus J Cameron, Andrew M Cotterill, Jennifer J Couper, Elizabeth A Davis, Kim C Donaghue, Craig A Jefferies, Bruce R King, Richard O Sinnott, Elaine B Tham, Jerry K Wales, Timothy W Jones and Maria E Craig
Med J Aust 2017; 206 (3): 121-125. || doi: 10.5694/mja16.00737

Summary

Objectives: To assess glycaemic control, anthropometry and insulin regimens in a national sample of Australian children and adolescents with type 1 diabetes.

Design: Cross-sectional analysis of de-identified, prospectively collected data from the Australasian Diabetes Data Network (ADDN) registry.

Setting: Five paediatric diabetes centres in New South Wales, Queensland, South Australia, Victoria and Western Australia.

Participants: Children and adolescents (aged 18 years or under) with type 1 diabetes of at least 12 months’ duration for whom data were added to the ADDN registry during 2015.

Main outcome measures: Glycaemic control was assessed by measuring haemoglobin A1c (HbA1c) levels. Body mass index standard deviation scores (BMI-SDS) were calculated according to the CDC-2000 reference; overweight and obesity were defined by International Obesity Task Force guidelines. Insulin regimens were classified as twice-daily injections (BD), multiple daily injections (MDI; at least three injection times per day), or continuous subcutaneous insulin infusion (CSII).

Results: The mean age of the 3279 participants was 12.8 years (SD, 3.7), mean diabetes duration was 5.7 years (SD, 3.7), and mean HbA1c level 67 mmol/mol (SD, 15); only 27% achieved the national HbA1c target of less than 58 mmol/mol. The mean HbA1c level was lower in children under 6 (63 mmol/mol) than in adolescents (14–18 years; 69 mmol/mol). Mean BMI-SDS for all participants was 0.6 (SD, 0.9); 33% of the participants were overweight or obese. 44% were treated with CSII, 38% with MDI, 18% with BD.

Conclusions: Most Australian children and adolescents with type 1 diabetes are not meeting the recognised HbA1c target. The prevalence of overweight and obesity is high. There is an urgent need to identify barriers to achieving optimal glycaemic control in this population.

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  • Helen Phelan1,2
  • Helen Clapin3,4
  • Loren Bruns5
  • Fergus J Cameron6
  • Andrew M Cotterill7,8
  • Jennifer J Couper9
  • Elizabeth A Davis10
  • Kim C Donaghue11
  • Craig A Jefferies12
  • Bruce R King1
  • Richard O Sinnott5
  • Elaine B Tham9
  • Jerry K Wales7,8
  • Timothy W Jones10
  • Maria E Craig2,11

  • 1 John Hunter Children's Hospital, Newcastle, NSW
  • 2 University of Sydney, Sydney, NSW
  • 3 Telethon Kids, Perth, WA
  • 4 Australasian Paediatric Endocrine Group, Australasian Diabetes Data Network, Lake Macquarie, NSW
  • 5 University of Melbourne, Melbourne, VIC
  • 6 Royal Children's Hospital, Melbourne, VIC
  • 7 Lady Cilento Children's Hospital, Brisbane, QLD
  • 8 University of Queensland, Brisbane, QLD
  • 9 Women's and Children's Hospital, Adelaide, SA
  • 10 Princess Margaret Hospital for Children, Perth, WA
  • 11 The Children's Hospital at Westmead, Sydney, NSW
  • 12 The Starship Children's Hospital, Auckland, New Zealand

Correspondence: m.craig@unsw.edu.au

Acknowledgements: 

This research was supported by the Australian Type 1 Diabetes Clinical Research Network, led by Juvenile Diabetes Research Foundation (JDRF) Australia, with additional funding by the Australian Research Council (through a Special Research Initiative) and the federal Department of Health and Ageing. Helen Phelan received a National Health and Medical Research Council (NHMRC) Public Health and Health Services Research Scholarship. We thank the staff of the JDRF Australian Type 1 Clinical Research Network, particularly Dorota Pawlak and Maryanne Ng, for ongoing support and guidance. We gratefully acknowledge the contribution and support of the Australasian Paediatric Endocrine Group (APEG) and Lyndell Wills, APEG Secretariat, and we also thank Albert Chan, Children’s Hospital Westmead, Sydney, and Girard Good, Telethon Kids Institute, Perth, for developing the clinical database and preparing data exports to the ADDN.

Competing interests:

No relevant disclosures.

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