BACKGROUND: Advances in paediatric type 1 diabetes management and increased use of diabetes technology have led to improvements in glycaemia, reduced risk of severe hypoglycaemia, and improved quality of life. Since 1993, progressively lower HbA1c targets have been set. The aim of this study was to perform a longitudinal analysis of HbA1c, treatment regimens, and acute complications between 2013 and 2022 using data from eight national and one international paediatric diabetes registries. METHODS: In this longitudinal analysis, we obtained data from the Australasian Diabetes Data Network, Czech National Childhood Diabetes Register, Danish Registry of Childhood and Adolescent Diabetes, Diabetes Prospective Follow-up Registry, Norwegian Childhood Diabetes Registry, England and Wales' National Paediatric Diabetes Audit, Swedish Childhood Diabetes Registry, T1D Exchange Quality Improvement Collaborative, and the SWEET initiative. All children (aged ≤18 years) with type 1 diabetes with a duration of longer than 3 months were included. Investigators compared data from 2013 to 2022; analyses performed on data were pre-defined and conducted separately by each respective registry. Data on demographics, HbA1c, treatment regimen, and event rates of diabetic ketoacidosis and severe hypoglycaemia were collected. ANOVA was performed to compare means between registries and years. Joinpoint regression analysis was used to study significant breakpoints in temporal trends. FINDINGS: In 2022, data were available for 109 494 children from the national registries and 35 590 from SWEET. Between 2013 and 2022, the aggregated mean HbA1c decreased from 8·2% (95% CI 8·1-8·3%; 66·5 mmol/mol [65·2-67·7]) to 7·6% (7·5-7·7; 59·4mmol/mol [58·2-60·5]), and the proportion of participants who had achieved HbA1c targets of less than 7% (<53 mmol/mol) increased from 19·0% to 38·8% (p<0·0001). In 2013, the aggregate event rate of severe hypoglycaemia rate was 3·0 events per 100 person-years (95% CI 2·0-4·9) compared with 1·7 events per 100 person-years (1·0-2·7) in 2022. In 2013, the aggregate event rate of diabetic ketoacidosis was 3·1 events per 100 person-years (95% CI 2·0-4·8) compared with 2·2 events per 100 person-years (1·4-3·4) in 2022. The proportion of participants with insulin pump use increased from 42·9% (95% CI 40·4-45·5) in 2013 to 60·2% (95% CI 57·9-62·6) in 2022 (mean difference 17·3% [13·8-20·7]; p<0·0001), and the proportion of participants using continuous glucose monitoring (CGM) increased from 18·7% (95% CI 9·5-28·0) in 2016 to 81·7% (73·0-90·4) in 2022 (mean difference 63·0% [50·3-75·7]; p<0·0001). INTERPRETATION: Between 2013 and 2022, glycaemic outcomes have improved, parallel to increased use of diabetes technology. Many children had HbA1c higher than the International Society for Pediatric and Adolescent Diabetes (ISPAD) 2022 target. Reassuringly, despite targeting lower HbA1c, severe hypoglycaemia event rates are decreasing. Even for children with type 1 diabetes who have access to specialised diabetes care and diabetes technology, further advances in diabetes management are required to assist with achieving ISPAD glycaemic targets. FUNDING: None. TRANSLATIONS: For the Norwegian, German, Czech, Danish and Swedish translations of the abstract see Supplementary Materials section.

• MeSH
• diabetes mellitus 1. typu * epidemiologie   krev   farmakoterapie   MeSH
• dítě MeSH
• glykovaný hemoglobin * analýza   MeSH
• hypoglykemie epidemiologie   MeSH
• hypoglykemika * terapeutické užití   MeSH
• kojenec MeSH
• krevní glukóza * analýza   MeSH
• lidé MeSH
• longitudinální studie MeSH
• mladiství MeSH
• předškolní dítě MeSH
• registrace * statistika a číselné údaje   MeSH
• regulace glykemie statistika a číselné údaje   metody   MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• teplizumab,
• MeSH
• diabetes mellitus 1. typu * diagnóza   prevence a kontrola   terapie   MeSH
• diabetes mellitus MeSH
• glykovaný hemoglobin analýza   MeSH
• humanizované monoklonální protilátky terapeutické užití   MeSH
• kontinuální monitorování glukózy MeSH
• krevní glukóza MeSH
• lidé MeSH
• regulace glykemie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

• MeSH
• analýza dat MeSH
• diabetes mellitus terapie   MeSH
• krevní glukóza * analýza   MeSH
• lidé MeSH
• regulace glykemie MeSH
• selfmonitoring glykemie metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

• Klíčová slova
• Freestyle Libre 2,
• MeSH
• diabetes mellitus terapie   MeSH
• glykovaný hemoglobin analýza   MeSH
• kontinuální monitorování glukózy * metody   MeSH
• krevní glukóza analýza   MeSH
• lidé MeSH
• regulace glykemie MeSH
• selfmonitoring glykemie metody   MeSH
• Check Tag
• lidé MeSH

• Klíčová slova
• chiglitazar,
• MeSH
• diabetes mellitus 2. typu * farmakoterapie   MeSH
• hypoglykemika aplikace a dávkování   terapeutické užití   MeSH
• inzulinová rezistence MeSH
• karbazoly MeSH
• lidé MeSH
• metabolický syndrom farmakoterapie   MeSH
• propionáty MeSH
• receptory aktivované proliferátory peroxizomů agonisté   MeSH
• regulace glykemie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• komentáře MeSH
• souhrny MeSH

INTRODUCTION: The aim of the study was to assess the differences in key parameters of type 1 diabetes (T1D) control associated with treatment and monitoring modalities including newly introduced hybrid closed-loop (HCL) algorithm in children and adolescents with T1D (CwD) using the data from the population-wide pediatric diabetes registry ČENDA. METHODS: CwD younger than 19 years with T1D duration >1 year were included and divided according to the treatment modality and type of CGM used: multiple daily injection (MDI), insulin pump without (CSII) and with HCL function, intermittently scanned continuous glucose monitoring (isCGM), real-time CGM (rtCGM), and intermittent or no CGM (noCGM). HbA1c, times in glycemic ranges, and glucose risk index (GRI) were compared between the groups. RESULTS: Data of a total of 3,251 children (mean age 13.4 ± 3.8 years) were analyzed. 2,187 (67.3%) were treated with MDI, 1,064 (32.7%) with insulin pump, 585/1,064 (55%) with HCL. The HCL users achieved the highest median TIR 75.4% (IQR 6.3) and lowest GRI 29.1 (7.8), both p < 0.001 compared to other groups, followed by MDI rtCGM and CSII groups with TIR 68.8% (IQR 9.0) and 69.0% (7.5), GRI 38.8 (12.5) and 40.1 (8.5), respectively (nonsignificant to each other). These three groups did not significantly differ in their HbA1c medians (51.8 [IQR 4.5], 50.7 [4.5], and 52.7 [5.7] mmol/mol, respectively). NoCGM groups had the highest HbA1c and GRI and lowest TIR regardless of the treatment modality. CONCLUSION: This population-based study shows that the HCL technology is superior to other treatment modalities in CGM-derived parameters and should be considered as a treatment of choice in all CwD fulfilling the indication criteria.

• MeSH
• diabetes mellitus 1. typu * farmakoterapie   MeSH
• dítě MeSH
• glykovaný hemoglobin MeSH
• hypoglykemika terapeutické užití   MeSH
• inzulin terapeutické užití   MeSH
• krevní glukóza MeSH
• lidé MeSH
• mladiství MeSH
• regulace glykemie MeSH
• selfmonitoring glykemie MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• Publikační typ
• časopisecké články MeSH

Publikace se zaměřuje na management diabetu mellitus u dětí. Určeno široké veřejnosti; dětem a rodičům.

• MeSH
• diabetes mellitus * MeSH
• diabetická dieta MeSH
• dítě MeSH
• inzulin MeSH
• regulace glykemie MeSH
• Check Tag
• dítě MeSH
• Publikační typ
• monografie MeSH
• populární práce MeSH

• Konspekt
• Pediatrie
• NLK Obory
• diabetologie
• pediatrie
• zdravotní výchova
• NLK Publikační typ
• literatura pro děti a mládež

• MeSH
• diabetes mellitus * farmakoterapie   MeSH
• glykovaný hemoglobin účinky léků   MeSH
• hypoglykemie MeSH
• hypoglykemika * aplikace a dávkování   terapeutické užití   MeSH
• klinické rozhodování MeSH
• lidé MeSH
• regulace glykemie metody   MeSH
• rekonciliace medikace MeSH
• revize medikace MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH
• komentáře MeSH
• souhrny MeSH

• Klíčová slova
• semaglutid, Rybelsus,
• MeSH
• aplikace orální MeSH
• diabetes mellitus 2. typu * farmakoterapie   MeSH
• glukagonu podobný peptid 1 * farmakologie   terapeutické užití   MeSH
• kongresy jako téma MeSH
• lidé MeSH
• regulace glykemie metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• zprávy MeSH

• MeSH
• adherence pacienta * MeSH
• diabetes mellitus 2. typu terapie   MeSH
• glykovaný hemoglobin analýza   MeSH
• lidé MeSH
• primární zdravotní péče MeSH
• randomizované kontrolované studie jako téma MeSH
• regulace glykemie * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• komentáře MeSH
• souhrny MeSH