Differences in Achieving Stringent Glycemic Targets Among Youth with Type 1 Diabetes: A SWEET Registry Study.
Publisher DOI
PubMed ID
42388060
Abstract
Aims
This study aimed to investigate the associations between glycemic outcomes and a range of clinical and demographic factors, including treatment modality, sex, age, diabetes duration, and body mass index, in youth with type 1 diabetes in an international registry.Methods
This observational, cross-sectional cohort study included youth <21 years from 23 countries. Proportions of individuals using different treatment modalities (continuous glucose monitoring [CGM] with injections, CGM with pump, automated insulin delivery [AID]) and achieving recommended time in tight range (TITR >50%), time in range (TIR >70%), and glycated hemoglobin (HbA1c) (≤6.5% [48 mmol/mol] and ≤7% [53 mmol/mol]) were assessed using mixed-effects fractional logistic and linear regression models. Sex, age (categorized), diabetes duration (categorized), body mass index standard deviation score (categorized), and treatment modality were included as covariates.Results
Data of 7691 individuals (mean [standard deviation] age of 13.7 [4.3] years, diabetes duration 6.3 [4.2] years, 47.8% female) were included. AID users were the most likely to achieve TITR target (adjusted mean [standard error of the mean] 41.2% [2.9]), followed by CGM with insulin pump (25.2% [2.3]) and CGM with injections (13.7% [1.5], P < 0.001). A similar association was observed for proportions of individuals achieving TIR and HbA1c targets (P < 0.001). Age <6 years was associated with a higher coefficient of variation (CV) (P < 0.001) and a lower probability of achieving both TITR and TIR targets compared with other age groups (P < 0.001). In analyses of TITR associated with mean sensor glucose stratified by CV, a higher TITR for a lower CV was observed only at mean glucose levels below 150-160 mg/dL; above this threshold, the pattern reversed, with lower CV associated with lower TITR at a given mean glucose level.Conclusions
Children younger than 6 years and individuals not using glucose-responsive insulin therapy were less likely to meet the recommended glycemic targets. It is imperative to minimize these disadvantages.
This study aimed to investigate the associations between glycemic outcomes and a range of clinical and demographic factors, including treatment modality, sex, age, diabetes duration, and body mass index, in youth with type 1 diabetes in an international registry.Methods
This observational, cross-sectional cohort study included youth <21 years from 23 countries. Proportions of individuals using different treatment modalities (continuous glucose monitoring [CGM] with injections, CGM with pump, automated insulin delivery [AID]) and achieving recommended time in tight range (TITR >50%), time in range (TIR >70%), and glycated hemoglobin (HbA1c) (≤6.5% [48 mmol/mol] and ≤7% [53 mmol/mol]) were assessed using mixed-effects fractional logistic and linear regression models. Sex, age (categorized), diabetes duration (categorized), body mass index standard deviation score (categorized), and treatment modality were included as covariates.Results
Data of 7691 individuals (mean [standard deviation] age of 13.7 [4.3] years, diabetes duration 6.3 [4.2] years, 47.8% female) were included. AID users were the most likely to achieve TITR target (adjusted mean [standard error of the mean] 41.2% [2.9]), followed by CGM with insulin pump (25.2% [2.3]) and CGM with injections (13.7% [1.5], P < 0.001). A similar association was observed for proportions of individuals achieving TIR and HbA1c targets (P < 0.001). Age <6 years was associated with a higher coefficient of variation (CV) (P < 0.001) and a lower probability of achieving both TITR and TIR targets compared with other age groups (P < 0.001). In analyses of TITR associated with mean sensor glucose stratified by CV, a higher TITR for a lower CV was observed only at mean glucose levels below 150-160 mg/dL; above this threshold, the pattern reversed, with lower CV associated with lower TITR at a given mean glucose level.Conclusions
Children younger than 6 years and individuals not using glucose-responsive insulin therapy were less likely to meet the recommended glycemic targets. It is imperative to minimize these disadvantages.
Date Issued
2026-07-02
Publication Type
Article
Subjects
artificial pancreas
•
glucose variability
•
pediatrics
•
time in range (TIR)
•
type 1 diabetes
Language(s)
en
Author(s)
Dovc, Klemen | |
Mianowska, Beata | |
Cardona-Hernandez, Roque | |
von dem Berge, Thekla | |
Davis, Elizabeth | |
Kosteria, Ioanna | |
Marigliano, Marco | |
Rami-Merhar, Birgit | |
Scharf, Mauro | |
Lanzinger, Stefanie |
Additional Credits
Journal
Diabetes Technology & Therapeutics
Publisher
SAGE Publications
ISSN
1557-8593
1520-9156
Access(Rights)
restricted