Five years of improving diabetes control in Czech children after the establishment of the population-based childhood diabetes register ČENDA
Language English Country United States Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
31605416
DOI
10.1111/pedi.12929
Knihovny.cz E-resources
- Keywords
- HbA1c, children, diabetes, register,
- MeSH
- Diabetes Mellitus, Type 1 diagnosis epidemiology therapy MeSH
- Diabetes Mellitus, Type 2 diagnosis epidemiology therapy MeSH
- Child MeSH
- Glycated Hemoglobin metabolism MeSH
- Hypoglycemic Agents therapeutic use MeSH
- Insulin therapeutic use MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Infant, Newborn MeSH
- Child, Preschool MeSH
- Registries * MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Infant, Newborn MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic epidemiology MeSH
- Names of Substances
- Glycated Hemoglobin A MeSH
- Hypoglycemic Agents MeSH
- Insulin MeSH
OBJECTIVES: The Czech National Childhood Diabetes Register (ČENDA) is a web-based nationwide database that collects treatment and outcome data in children and adolescents with diabetes. Here, we present data from the first 5 years of ČENDA (2013-2017). METHODS: Data include characteristics of disease onset and annual summaries of key clinical care parameters from every patient treated by participating pediatric diabetes outpatient clinics. RESULTS: The database contains data of 4361 children (aged 0-19 years) from 52 centers (85% of all Czech pediatric patients). Of these, 94% had type 1 diabetes (T1D), 4.5% had genetically proven monogenic or secondary, and 1.5% had type 2 diabetes. In children with T1D, median glycated hemoglobin (HbA1c) decreased throughout the observed period from 66.3 to 61.0 mmol/mol (P < .0001, 95% confidence interval [CI] for change -5.6 to -4 mmol/mol). Consequently, the proportion of children reaching the target therapeutic goal of 58.5 mmol/mol increased from 28% in 2013 to 40% in 2017. The proportion of children treated with insulin pumps (CSII) remained stable over the observed period (25%). In a subanalysis of 1602 patients (long-standing T1D diagnosed before 2011), the main predictors associated with lower HbA1c were treatment with CSII, male sex and care provided at a large diabetes center (>100 patients). CONCLUSIONS: A significant continuous decrease in HbA1c was observed in Czech children over the past 5 years. As this improvement was not accompanied by appreciable changes in the mode of therapy, we assume that the establishment of our nationwide register has itself constituted a stimulus towards improvement in the care process.
Department of Pediatrics 3rd Faculty of Medicine Prague Czech Republic
Department of Pediatrics Hospital České Budějovice České Budějovice Czech Republic
Department of Pediatrics Masaryk Hospital Ústí nad Labem Ústí nad Labem Czech Republic
Department of Pediatrics University Hospital Brno Brno Czech Republic
Department of Pediatrics University Hospital Hradec Králové Czech Republic
Department of Pediatrics University Hospital Olomouc Olomouc Czech Republic
Department of Pediatrics University Hospital Ostrava Ostrava Czech Republic
Department of Pediatrics University Hospital Pilsen Pilsen Czech Republic
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