liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
BETA
Samuelsson, Ulf
Publications (10 of 60) Show all publications
Jonsdottir, B., Larsson, C., Carlsson, A., Forsander, G., Ivarsson, S. A., Lernmark, Å., . . . Elding Larsson, H. (2017). Thyroid and islet autoantibodies predict autoimmune thyroid disease already at Type 1 diabetes diagnosis.. Journal of Clinical Endocrinology and Metabolism, 102(4), 1277-1285
Open this publication in new window or tab >>Thyroid and islet autoantibodies predict autoimmune thyroid disease already at Type 1 diabetes diagnosis.
Show others...
2017 (English)In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 102, no 4, p. 1277-1285Article in journal (Refereed) Published
Abstract [en]

CONTEXT: Screening of autoimmune thyroid disease in children and young adults with Type 1 diabetes is important but vary greatly between clinics.

OBJECTIVE: The aim was to determine the predictive value of thyroid autoantibodies, thyroid function, islet autoantibodies, and HLA- DQ at diagnosis of Type 1 diabetes for autoimmune thyroid disease during subsequent follow-up.

SETTING: 43 Paediatric Endocrinology units Sweden. Design, patients and main outcome measures: At diagnosis of Type 1 diabetes, samples from 2433 children were analysed for autoantibodies against thyroid peroxidase (TPOAb), thyroglobulin (TGAb), glutamic acid decarboxylase (GADA), insulin (IAA), insulinoma-associated protein-2 (IA-2A), and the three variants of the zinc transporter 8 (ZnT8W/R/QA) as well as HLA-DQA1-B1 genotypes and thyroid function. After 5.1-9.5 years disease duration, children treated with thyroxine were identified in the Swedish National Board of Health and Welfare Prescribed Drug Register.

RESULTS: Thyroxine had been prescribed to 6% (147/2433; 66% girls). In patients below 5 years, female gender (HR=4.60, p=0.008) and GADA (HR=5.80, p=0.02) were significant predictors. In patients 5-10 years, TPOAb (HR=20.56, p<0.0001), TGAb (HR=3.40, p=0.006) and TSH outside the reference limit (HR=3.64, p<0.001) were predictors while in the 10-15 year olds, TPOAb (HR=17.00, p<0.001) and TSH outside the reference limit (HR=4.11, p<0.001) predicted future thyroxine prescription.

CONCLUSION: In addition to TPOAb and TSH, positive GADA tested at the diagnosis of type 1 diabetes is important for the prediction of autoimmune thyroid disease in children below 5 years of age.

Place, publisher, year, edition, pages
Oxford University Press, 2017
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-134863 (URN)10.1210/jc.2016-2335 (DOI)000402195300021 ()27740884 (PubMedID)
Note

Funding agencies: Swedish Research Council [14064]; Swedish Child Diabetes Foundation; Swedish Diabetes Association; National Institutes of Health [DK26190]; SUS Fund; Knut and Alice Wallenberg Foundation; Skane County Council for Research and Development

Available from: 2017-02-27 Created: 2017-02-27 Last updated: 2018-05-03
Ping Zhao, L., Alshiekh, S., Zhao, M., Carlsson, A., Elding Larsson, H., Forsander, G., . . . Lernmark, A. (2016). Next-Generation Sequencing Reveals That HLA-DRB3, -DRB4, and -DRB5 May Be Associated With Islet Autoantibodies and Risk for Childhood Type 1 Diabetes. Diabetes, 65(3), 710-718
Open this publication in new window or tab >>Next-Generation Sequencing Reveals That HLA-DRB3, -DRB4, and -DRB5 May Be Associated With Islet Autoantibodies and Risk for Childhood Type 1 Diabetes
Show others...
2016 (English)In: Diabetes, ISSN 0012-1797, E-ISSN 1939-327X, Vol. 65, no 3, p. 710-718Article in journal (Refereed) Published
Abstract [en]

The possible contribution of HLA-DRB3, -DRB4, and -DRB5 alleles to type 1 diabetes risk and to insulin autoantibody (IAA), GAD65 (GAD autoantibody [GADA]), IA-2 antigen (IA-2A), or ZnT8 against either of the three amino acid variants R, W, or Q at position 325 (ZnT8RA, ZnT8WA, and ZnT8QA, respectively) at clinical diagnosis is unclear. Next-generation sequencing (NGS) was used to determine all DRB alleles in consecutively diagnosed patients ages 1-18 years with islet autoantibody-positive type 1 diabetes (n = 970) and control subjects (n = 448). DRB3, DRB4, or DRB5 alleles were tested for an association with the risk of DRB1 for autoantibodies, type 1 diabetes, or both. The association between type 1 diabetes and DRB1*03:01:01 was affected by DRB3*01:01:02 and DRB3*02:02:01. These DRB3 alleles were associated positively with GADA but negatively with ZnT8WA, IA-2A, and IAA. The negative association between type 1 diabetes and DRB1*13:01:01 was affected by DRB3*01:01:02 to increase the risk and by DRB3*02:02:01 to maintain a negative association. DRB4*01:03:01 was strongly associated with type 1 diabetes (P = 10(-36)), yet its association was extensively affected by DRB1 alleles from protective (DRB1*04:03:01) to high (DRB1*04:01:01) risk, but its association with DRB1*04:05:01 decreased the risk. HLA-DRB3, -DRB4, and -DRB5 affect type 1 diabetes risk and islet autoantibodies. HLA typing with NGS should prove useful to select participants for prevention or intervention trials.

Place, publisher, year, edition, pages
AMER DIABETES ASSOC, 2016
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-126246 (URN)10.2337/db15-1115 (DOI)000370961000024 ()26740600 (PubMedID)
Note

Funding Agencies|European Foundation for the Study of Diabetes Clinical Research Grants Programme; Swedish Child Diabetes Foundation; National Institutes of Health [DK-63861, DK-26190]; Swedish Research Council; Linne grant; Skane County Council for Research and Development; Swedish Association of Local Authorities and Regions; Knut and Alice Wallenberg Foundation

Available from: 2016-03-21 Created: 2016-03-21 Last updated: 2017-11-30
Samuelsson, U., Anderzen, J., Gudbjornsdottir, S., Steineck, I., Akesson, K. & Hanberger, L. (2016). Teenage girls with type 1 diabetes have poorer metabolic control than boys and face more complications in early adulthood. Journal of diabetes and its complications, 30(5), 917-922
Open this publication in new window or tab >>Teenage girls with type 1 diabetes have poorer metabolic control than boys and face more complications in early adulthood
Show others...
2016 (English)In: Journal of diabetes and its complications, ISSN 1056-8727, E-ISSN 1873-460X, Vol. 30, no 5, p. 917-922Article in journal (Refereed) Published
Abstract [en]

Aims: To compare metabolic control between males and females with type 1 diabetes during adolescence and as young adults, and relate it to microvascular complications. Methods: Data concerning 4000 adolescents with type 1 diabetes registered in the Swedish paediatric diabetes quality registry, and above the age of 18 years in the Swedish National Diabetes Registry was used. Results: When dividing HbA1c values in three groups; amp;lt; 7.4% (57 mmol/mol), 7.4-93% (57-78 mmol/mol) and amp;gt;9.3% (78 mmol/mol), there was a higher proportion of females in the highest group during adolescence. In the group with the highest HbA1c values during adolescence and as adults, 51.7% were females, expected value 46.2%; in the group with low HbA1c values in both registries, 34.2% were females, p amp;lt; 0.001. As adults, more females had retinopathy, p amp;lt; 0.05. Females had higher mean HbAlc values at diagnosis, 112 vs. 10.9% (99 vs. 96 mmol/mol), p amp;lt; 0.03, during adolescence, 8.5 vs. 82% (69 vs. 66 mmol/mol) p amp;lt; 0.01, but not as young adults. Conclusions: Worse glycaemic control was found in adolescent females, and they had a higher frequency of microvascular complications. Improved paediatric diabetes care is of great importance for increasing the likelihood of lower mortality and morbidity later in life. (C) 2016 Elsevier Inc. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC, 2016
Keyword
HbA1c; Type 1 diabetes; Gender; Microvascular complications; Quality of care
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-130403 (URN)10.1016/j.jdiacomp.2016.02.007 (DOI)000378759700028 ()27052153 (PubMedID)
Note

Funding Agencies|Association of Local Authorities and Regions, SALAR; Futurum - Academy for Health and Care, Jonkoping County Council, Sweden

Available from: 2016-08-15 Created: 2016-08-05 Last updated: 2017-11-28
Anderzen, J., Samuelsson, U., Gudbjornsdottir, S., Hanberger, L. & Akesson, K. (2016). Teenagers with poor metabolic control already have a higher risk of microvascular complications as young adults. Journal of diabetes and its complications, 30(3), 533-536
Open this publication in new window or tab >>Teenagers with poor metabolic control already have a higher risk of microvascular complications as young adults
Show others...
2016 (English)In: Journal of diabetes and its complications, ISSN 1056-8727, E-ISSN 1873-460X, Vol. 30, no 3, p. 533-536Article in journal (Refereed) Published
Abstract [en]

Aims: To evaluate how HbA1c in adolescents with type 1 diabetes affects microvascular complications in young adults. Methods: All individuals registered in the Swedish paediatric diabetes quality registry (SWEDIABKIDS) 13-18 years of age, and as adults registered in the Swedish National Diabetes Registry (NDR) in both the years 2011 and 2012 were included, in total 4250 individuals. Results: Of the individuals with mean HbA1c &gt;78 mmol/mol in SWEDIABKIDS 83.4% had retinopathy, 15.8% had microalbuminuria and 4.9% had macroalbuminuria in NDR. The logistic regression analysis showed that the OR to develop macroalbuminuria as a young adult was significantly higher in the group with mean HbA1c &gt;78 mmol/mol in SWEDIABKIDS (p &lt; 0.05). Among the patients with mean HbA1c above 78 mmol/mol in both registries there was a significantly higher proportion that had retinopathy, microalbuminuria (p &lt; 0.001) and/or macroalbuminuria (p &lt; 0.01) compared to the group with HbA1c below 57 mmol/mol in both registries. Only 6.5% of the persons in this study were over 30 years of age. Conclusions: Paediatric diabetes teams working with teenagers must be aware of the impact of good metabolic control during adolescence, and should intensify the care during this vulnerable period of life to reduce the risk of microvascular complications in young adults.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC, 2016
Keyword
Type 1 diabetes; Teenagers; National quality register; Metabolic control; Microvasular complications
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-127423 (URN)10.1016/j.jdiacomp.2015.12.004 (DOI)000372940300024 ()26775554 (PubMedID)
Note

Funding Agencies|Ostergotland County Council; Futurum the Academy for Health and Care; Jonkoping County Council; FORSS- Medical Research Council of Southeast Sweden

Available from: 2016-05-01 Created: 2016-04-26 Last updated: 2017-11-30
Samuelsson, U., Lindell, N., Bladh, M., Akesson, K., Carlsson, A. & Josefsson, A. (2015). Caesarean section per se does not increase the risk of offspring developing type 1 diabetes: a Swedish population-based study. Diabetologia, 58(11), 2517-2524
Open this publication in new window or tab >>Caesarean section per se does not increase the risk of offspring developing type 1 diabetes: a Swedish population-based study
Show others...
2015 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 58, no 11, p. 2517-2524Article in journal (Refereed) Published
Abstract [en]

Aims/hypothesis Some studies have revealed a relationship between Caesarean section (CS) and type 1 diabetes, while other studies have not. By using the Swedish paediatric quality register we investigated whether birth by CS is related to the risk of developing type 1 diabetes during childhood. Methods All children diagnosed with type 1 diabetes from 2000 to 2012 and included in the register (n= 9,376) were matched with four controls by year, day of birth, sex and county of birth from the Swedish Medical Birth Register. Results Overall, 13.5% of deliveries were by CS. By group, 14.7% of children who developed type 1 diabetes were delivered by CS compared with 13.3% of control children (p less than 0.001). Mothers with diabetes more often gave birth by CS than mothers without diabetes (78.8% vs 12.7%, p less than 0.001). In a logistic regression model adjusting for maternal age, maternal diabetes and BMI in early pregnancy, the OR for CS was 1.0. A child who developed type 1 diabetes and had a mother with type 1 diabetes at the time of delivery had the highest OR to have been born by CS. Children of mothers without diabetes, delivered by CS, had no increased risk of developing type 1 diabetes. Maternal diabetes was the strongest predictor of childhood diabetes (OR 3.4), especially if the mother had type 1 diabetes (OR 7.54). Conclusions/interpretation CS had no influence on the risk of type 1 diabetes during childhood or adolescence. However, maternal diabetes itself strongly increased the risk of offspring developing type 1 diabetes.

Place, publisher, year, edition, pages
SPRINGER, 2015
Keyword
Caesarean section; Epidemiology; Pregnancy; Sex; Type 1 diabetes
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-122188 (URN)10.1007/s00125-015-3716-3 (DOI)000361993000008 ()26298452 (PubMedID)
Note

Funding Agencies|Futurum, the academy for health care, Jonkoping county council

Available from: 2015-10-26 Created: 2015-10-23 Last updated: 2017-12-01
Akesson, K., Hanberger, L. & Samuelsson, U. (2015). The influence of age, gender, insulin dose, BMI, and blood pressure on metabolic control in young patients with type 1 diabetes. Pediatric Diabetes, 16(8), 581-586
Open this publication in new window or tab >>The influence of age, gender, insulin dose, BMI, and blood pressure on metabolic control in young patients with type 1 diabetes
2015 (English)In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 16, no 8, p. 581-586Article in journal (Refereed) Published
Abstract [en]

ObjectiveTo explore the relationship between certain clinical variables and metabolic HbA1c at diagnosis correlated to HbA1c at follow-up (p less than 0.001). There was a clear gender difference regarding HbA1c. Girls had higher values both at diagnosis and at follow-up (p less than 0.001). Girls also had lower BMI and pH at diagnosis than boys (p less than 0.001). In contrast, girls with the highest body mass index (BMI) at follow-up had higher mean HbA1c at follow-up in 2010 (p less than 0.001). Having a mother and/or a father with high BMI implied higher HbA1c at diagnosis (p less than 0.003). ConclusionsHbA1c at diagnosis seems to predict metabolic control years later. There is a gender difference at diagnosis as female patients have higher HbA1c than males at diagnosis as well as at follow up. As metabolic control is very much correlated to complications there is a need to early identify patients at risk of poor metabolic control. Even though we do not know whether a high HbA1c level is mainly due to severity of the disease or to behavioral patterns, new ways to treat and support these children, especially girls, are needed.

Place, publisher, year, edition, pages
WILEY-BLACKWELL, 2015
Keyword
children; gender; HbA1c; metabolic control; quality register; type 1 diabetes
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-123060 (URN)10.1111/pedi.12219 (DOI)000363929400003 ()25270077 (PubMedID)
Note

Funding Agencies|Ostergotland County Council; academy for Health and Care; Jonkoping County Council; Futurum

Available from: 2015-12-04 Created: 2015-12-03 Last updated: 2017-12-01
Petersson, C., Huus, K., Samuelsson, U., Hanberger, L. & Akesson, K. (2015). Use of the national quality registry to monitor health-related quality of life of children with type I diabetes: A pilot study. Journal of Child Health Care, 19(1), 30-42
Open this publication in new window or tab >>Use of the national quality registry to monitor health-related quality of life of children with type I diabetes: A pilot study
Show others...
2015 (English)In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 19, no 1, p. 30-42Article in journal (Refereed) Published
Abstract [en]

The management of diabetes is complicated, as treatment affects the everyday life of both children and their families. To enable optimal care for children with type I diabetes, it is important to highlight health-related quality of life (HrQoL) as well as medical outcomes to detect psychological problems that otherwise could be missed. The aim was to study HrQoL in children and adolescents with type I diabetes dependent on gender, age and co-morbidity and to study the consistency between childrens self-reporting and parents proxy reporting. The cross-sectional data were collected using the questionnaire DISABKIDS Chronic Generic Measure and the DISABKIDS diabetes module. Parents in the proxy report perceived their childrens HrQoL to be lower than children themselves. Boys reported their HrQoL to be better than girls. Results show that living with an additional disease has an impact on the HrQoL, which is an important factor to consider in the quality registry. Assessing HrQoL on a routine basis may facilitate detection and discussion of HrQoL-related questions in the national quality registry.

Place, publisher, year, edition, pages
SAGE Publications (UK and US), 2015
Keyword
Assessment; diabetes; paediatric; statistics
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-117244 (URN)10.1177/1367493513496674 (DOI)000351302500004 ()23975719 (PubMedID)
Available from: 2015-04-22 Created: 2015-04-21 Last updated: 2017-12-04
Samuelsson, U., Steineck, I. & Gubbjornsdottir, S. (2014). A high mean-HbA1c value 3-15 months after diagnosis of type 1 diabetes in childhood is related to metabolic control, macroalbuminuria, and retinopathy in early adulthood - a pilot study using two nation-wide population based quality registries. Pediatric Diabetes, 15(3), 229-235
Open this publication in new window or tab >>A high mean-HbA1c value 3-15 months after diagnosis of type 1 diabetes in childhood is related to metabolic control, macroalbuminuria, and retinopathy in early adulthood - a pilot study using two nation-wide population based quality registries
2014 (English)In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 15, no 3, p. 229-235Article in journal (Refereed) Published
Abstract [en]

BackgroundIntensive treatment of patients with type 1 diabetes delays the onset of long-term complications. ObjectivesOn the basis of the information from two nation-wide quality registers, we investigated to which extent HbA1c values 3-15months after diagnosis in childhood are related to metabolic control, albuminuria, and retinopathy in early adulthood. MethodsIn Sweden, physicians register all children and adolescents with type 1 diabetes mellitus in the Swedish Pediatric Quality Registry. After 18yr of age, people with diabetes are followed by the Swedish National Diabetes Register. We identified 1543 children and adolescents with a mean age of 13.9yr at diagnosis and a mean duration of type 1 diabetes mellitus of 7.1yr. ResultsChildren and adolescents with poor metabolic control (mean HbA1c 70mmol/mol (8.6 %)) adjacent to diagnosis had a significantly higher mean HbA1c value years later as adults than did patients with a good metabolic control [less than50mmol/mol (6.7%) (pless than0.001)]. The patients in the high group were also less physically active and smoked more as adults. The proportion of females was higher in the poor metabolic group. Patients with a high mean HbA1c 3-15months after diagnosis had significantly more often macroalbuminuria and retinopathy in early adulthood. ConclusionsMetabolic control adjacent to the diagnosis of type 1 diabetes in childhood or adolescence can predict metabolic control in early adulthood. It is therefore very important that pediatric diabetes teams identify key factors for successful early metabolic control. Actively using quality registries may be one such factor.

Place, publisher, year, edition, pages
Wiley, 2014
Keyword
albuminuria; HbA1c quality register; retinopathy
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-107850 (URN)10.1111/pedi.12085 (DOI)000335836000010 ()
Available from: 2014-06-23 Created: 2014-06-23 Last updated: 2017-12-05
Svensson, M., Ramelius, A., Nilsson, A.-L., Delli, A., Elding Larsson, H., Carlsson, A., . . . Lernmark, A. (2014). Antibodies to Influenza Virus A/H1N1 Hemagglutinin in Type 1 Diabetes Children Diagnosed Before, During and After the SWEDISH A(H1N1)pdm09 Vaccination Campaign 2009-2010. Scandinavian Journal of Immunology, 79(2), 137-148
Open this publication in new window or tab >>Antibodies to Influenza Virus A/H1N1 Hemagglutinin in Type 1 Diabetes Children Diagnosed Before, During and After the SWEDISH A(H1N1)pdm09 Vaccination Campaign 2009-2010
Show others...
2014 (English)In: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 79, no 2, p. 137-148Article in journal (Refereed) Published
Abstract [en]

We determined A/H1N1-hemagglutinin (HA) antibodies in relation to HLAD-Q genotypes and islet autoantibodies at clinical diagnosis in 1141 incident 0.7 to 18-year-old type 1 diabetes patients diagnosed April 2009-December 2010. Antibodies to S-35-methionine-labelled A/H1N1 hemagglutinin were determined in a radio-binding assay in patients diagnosed before (n = 325), during (n = 355) and after (n = 461) the October 2009-March 2010 Swedish A(H1N1) pdm09 vaccination campaign, along with HLA-DQ genotypes and autoantibodies against GAD, insulin, IA-2 and ZnT8 transporter. Before vaccination, 0.6% patients had A/H1N1-HA antibodies compared with 40% during and 27% after vaccination (P less than 0.0001). In children less than3 years of age, A/H1N1-HA antibodies were found only during vaccination. The frequency of A/H1N1-HA antibodies during vaccination decreased after vaccination among the 3 less than 6 (P = 0.006) and 13 less than 18 (P = 0.001), but not among the 6 less than 13-year-olds. HLA-DQ2/8 positive children less than3 years decreased from 54% (15/28) before and 68% (19/28) during, to 30% (9/30) after vaccination (P = 0.014). Regardless of age, DQ2/2; 2/X (n = 177) patients had lower frequency (P = 0.020) and levels (P = 0.042) of A/H1N1-HA antibodies compared with non-DQ2/2; 2/X (n = 964) patients. GADA frequency was 50% before, 60% during and 51% after vaccination (P = 0.009). ZnT8QA frequency increased from 30% before to 34% during and 41% after vaccination (P = 0.002). Our findings suggest that young (less than3 years) along with DQ2/2; 2/X patients were low responders to Pandemrix (R). As the proportion of DQ2/8 patients less than3 years of age decreased after vaccination and the frequencies of GADA and ZnT8QA were enhanced, it cannot be excluded that the vaccine affected clinical onset of type 1 diabetes.

Place, publisher, year, edition, pages
Wiley, 2014
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-107865 (URN)10.1111/sji.12138 (DOI)000336525900009 ()
Available from: 2014-06-23 Created: 2014-06-23 Last updated: 2017-12-05
Hanberger, L., Birkebaek, N., Bjarnason, R., Drivvoll, A. K., Johansen, A., Skrivarhaug, T., . . . Samuelsson, U. (2014). Childhood diabetes in the nordic countries: a comparison of quality registries.. Journal of diabetes science and technology, 8(4), 738-44
Open this publication in new window or tab >>Childhood diabetes in the nordic countries: a comparison of quality registries.
Show others...
2014 (English)In: Journal of diabetes science and technology, ISSN 1932-2968, Vol. 8, no 4, p. 738-44Article in journal (Refereed) Published
Abstract [en]

In 2008 a Nordic collaboration was established between the quality registries in Denmark, Iceland, Norway, and Sweden to improve quality of care for children with diabetes. This study aimed to describe those registries and confirm that the registry variables are comparable. Selected variables were used to demonstrate outcome measurements. The organization of the registries and methodology are described. Cross-sectional data for patients between birth and 14.9 years with type 1 diabetes mellitus in 2009 (n = 6523) from 89 centers were analyzed. Variables were age, gender, and diabetic ketoacidosis at onset, together with age, gender, HbA1c, insulin regimen, and severe hypoglycemia at follow-up in 2009. All 4 registries use a standardized registration at the onset of diabetes and at follow-up, conducted at the local pediatric diabetes centers. Methods for measuring HbA1c varied as did methods of registration for factors such as hypoglycemia. No differences were found between the outcomes of the clinical variables at onset. Significant variations were found at follow-up for mean HbA1c, the proportion of children with HbA1c < 57 mmol/mol (NGSP/DCCT 7.4%), (range 15-31%), the proportion with insulin pumps (range 34-55%), and the numbers with severe hypoglycemia (range 5.6-8.3/100 patient years). In this large unselected population from 4 Nordic countries, a high proportion did not reach their treatment target, indicating a need to improve the quality of pediatric diabetes care. International collaboration is needed to develop and harmonize quality indicators and offers possibilities to study large geographic populations, identify problems, and share knowledge.

Place, publisher, year, edition, pages
Sage Publications, 2014
National Category
General Practice
Identifiers
urn:nbn:se:liu:diva-115300 (URN)10.1177/1932296814531479 (DOI)24876421 (PubMedID)
Available from: 2015-03-12 Created: 2015-03-12 Last updated: 2018-01-11Bibliographically approved
Organisations

Search in DiVA

Show all publications