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Samuelsson, Ulf
Publications (10 of 64) Show all publications
Samuelsson, U., Åkesson, K., Peterson, A., Hanas, R. & Hanberger, L. (2018). Continued improvement of metabolic control in Swedish pediatric diabetes care. Pediatric Diabetes, 19(1), 150-157
Open this publication in new window or tab >>Continued improvement of metabolic control in Swedish pediatric diabetes care
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2018 (English)In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 19, no 1, p. 150-157Article in journal (Refereed) Published
Abstract [en]

Background: To prospectively investigate if the grand mean HbA1c and the differences in mean HbA1c between centers in Sweden could be reduced, thereby improving care delivered by pediatric diabetes teams. Methods: We used an 18-month quality improvement collaborative (QIC) together with the Swedish pediatric diabetes quality registry (SWEDIABKIDS). The first program (IQ-1), started in April 2011 and the second (IQ-2) in April 2012; together they encompassed 70% of Swedish children and adolescents with diabetes. Results: The proportion of patients in IQ-1 with a mean HbA1c amp;lt;7.4% (57 mmol/mol) increased from 26.4% before start to 35.9% at 36 months (P amp;lt; .001), and from 30.2% to 37.2% (P amp;lt; .001) for IQ-2. Mean HbA1c decreased in both participating and non-participating (NP) centers in Sweden, thereby indicating an improvement by a spatial spill over effect in NP centers. The grand mean HbA1c decreased by 0.45% (4.9 mmol/mol) during 36 months; at the end of 2014 it was 7.43% (57.7 mmol/mol) (P amp;lt; .001). A linear regression model with the difference in HbA1c before start and second follow-up as dependent variable showed that QIC participation significantly decreased mean HbA1c both for IQ-1 and IQ-2. The proportion of patients with high HbA1c values (amp;gt;8.7%, 72 mmol/mol) decreased significantly in both QICs, while it increased in the NP group. Conclusions: The grand mean HbA1c has decreased significantly in Sweden from 2010 to 2014, and QICs have contributed significantly to this decrease. There seems to be a spatial spill-over effect in NP centers.

Place, publisher, year, edition, pages
WILEY, 2018
Keywords
diabetes mellitus type 1; hemoglobin A1c protein; human; pediatrics; quality of health care
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-145124 (URN)10.1111/pedi.12467 (DOI)000423397600021 ()27807917 (PubMedID)
Note

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

Available from: 2018-02-19 Created: 2018-02-19 Last updated: 2019-05-02
Lindell, N., Carlsson, A., Josefsson, A. & Samuelsson, U. (2018). Maternal obesity as a risk factor for early childhood type 1 diabetes: a nationwide, prospective, population-based case-control study. Diabetologia, 61(1), 130-137
Open this publication in new window or tab >>Maternal obesity as a risk factor for early childhood type 1 diabetes: a nationwide, prospective, population-based case-control study
2018 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 61, no 1, p. 130-137Article in journal (Refereed) Published
Abstract [en]

Genetic and environmental factors are believed to cause type 1 diabetes. The aim of this study was to investigate the influence of maternal BMI and gestational weight gain on the subsequent risk of childhood type 1 diabetes. Children in the Swedish National Quality Register for Diabetes in Children were matched with control children from the Swedish Medical Birth Register. Children were included whose mothers had data available on BMI in early pregnancy and gestational weight gain, giving a total of 16,179 individuals: 3231 children with type 1 diabetes and 12,948 control children. Mothers of children with type 1 diabetes were more likely to be obese (9% [n = 292/3231] vs 7.7% [n = 991/12,948]; p = 0.02) and/or have diabetes themselves (2.8% [n = 90/3231] vs 0.8% [n = 108/12,948]; p amp;lt; 0.001) compared with mothers of control children. Gestational weight gain did not differ significantly between the two groups of mothers. In mothers without diabetes, maternal obesity was a significant risk factor for type 1 diabetes in the offspring (p = 0.04). A child had an increased risk of developing type 1 diabetes if the mother had been obese in early pregnancy (crude OR 1.20; 95% CI 1.05, 1.38; adjusted OR 1.18; 95% CI 1.02, 1.36). Among children with type 1 diabetes (n = 3231) there was a difference (p amp;lt; 0.001) in age at onset in relation to the mothers BMI. Among children in the oldest age group (15-19 years), there were more mothers who had been underweight during pregnancy, while in the youngest age group (0-4 years) the pattern was reversed. Maternal obesity, in the absence of maternal diabetes, is a risk factor for type 1 diabetes in the offspring, and influences the age of onset of type 1 diabetes. This emphasises the importance of a normal maternal BMI to potentially decrease the incidence of type 1 diabetes.

Place, publisher, year, edition, pages
SPRINGER, 2018
Keywords
Age at onset; BMI; Gestational weight gain; Obesity; Pregnancy; Type 1 diabetes
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-143896 (URN)10.1007/s00125-017-4481-2 (DOI)000417272300016 ()29098322 (PubMedID)
Note

Funding Agencies|SALAR; ALF Grants, Region Ostergotland

Available from: 2018-01-02 Created: 2018-01-02 Last updated: 2019-06-28
Forsander, G., Stallknecht, S., Samuelsson, U., Marcus, C. & Bogelund, M. (2018). Preferences for treatment among adolescents with Type 1 diabetes: a national study using a discrete choice experiment model. Diabetic Medicine, 35(5), 621-629
Open this publication in new window or tab >>Preferences for treatment among adolescents with Type 1 diabetes: a national study using a discrete choice experiment model
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2018 (English)In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 35, no 5, p. 621-629Article in journal (Refereed) Published
Abstract [en]

AimTo test the possibility of using a discrete choice experiment model, on a national level in adolescents with Type 1 diabetes, in order to obtain a better understanding of drivers of and barriers to diabetes self-care. MethodsA survey instrument was constructed and tested on a small group of the target population: adolescents aged 15 to amp;lt;18 years with Type 1 diabetes. All individuals in Sweden belonging to this target group (N=2112) were then identified via the Swedish paediatric diabetes quality registry SWEDIABKIDS, and were sent an invitation to answer an online questionnaire. A valid response for the discrete choice experiment analyses was achieved from 431 individuals. ResultsThe included respondents were not statistically different from non-participants in terms of age and duration of diabetes, but more young women entered the study and the participants had (on average) a significantly lower HbA(1c) value than the non-participants. Participants regarded as undesirable both non-severe hypoglycaemic events (day and night) and hyperglycaemic events. Avoiding weight gain and even achieving weight loss were the most important aspects among female respondents, who were willing to trade off a substantial level of glycaemic control [13 mmol/mol (1.2%)] to avoid a weight gain of 3 kg. Hypothetical equipment improvements were desired. ConclusionsThe responses may provide useful indications of the aspects that the respondents would prioritize given a real-life dilemma. For treatment effects, stratification along gender lines was important, whereas the treatment administration aspects were stratified according to treatment type because these aspects are closely related.

Place, publisher, year, edition, pages
WILEY, 2018
National Category
General Practice
Identifiers
urn:nbn:se:liu:diva-147789 (URN)10.1111/dme.13592 (DOI)000430118900012 ()29381816 (PubMedID)
Note

Funding Agencies|Novo Nordisk

Available from: 2018-05-17 Created: 2018-05-17 Last updated: 2019-05-01
Hanberger, L., Samuelsson, U., Holl, R. W., Froehlich-Reiterer, E., Åkesson, K. & Hofer, S. (2018). Type 1 diabetes during adolescence: International comparison between Germany, Austria, and Sweden. Pediatric Diabetes, 19(3), 506-511
Open this publication in new window or tab >>Type 1 diabetes during adolescence: International comparison between Germany, Austria, and Sweden
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2018 (English)In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 19, no 3, p. 506-511Article in journal (Refereed) Published
Abstract [en]

Objectives: By using pediatric diabetes quality registries in Austria, Germany, and Sweden treatment of type 1 diabetes and the outcome of care during the vulnerable adolescence period were compared. Methods: Data in DPV, broadly used in Austria and Germany, and Swediabkids used in Sweden, from clinical visits in the year 2013 on 14 383 patients aged 11 to 16 years regarding hemoglobin A1c (HbA1c), insulin regimen, body mass index (BMI)-SD score (SDS), blood pressure, hypoglycemia, ketoacidosis, and smoking habits were analyzed. Results: Patients in Sweden had fewer clinical visits per year (P amp;lt; .05), lower insulin dose per kg (P amp;lt; .001), and lower proportion of fast acting insulin compared with Germany and Austria (P amp;lt; .001). The proportion of pump users was higher in Sweden (P amp;lt; .001). Patients in Sweden had lower mean HbA1c levels (Austria: 64 mmol/mol, Germany: 63 mmol/mol, and Sweden: 61 mmol/mol [8.0%, 7.9%, and 7.7%, respectively]; P amp;lt; .001). The frequency of severe hypoglycemia was higher in Sweden while it was lower for ketoacidosis (3.3% and 1.1%, respectively) than in Austria (1.1% and 5.3%) and Germany (2.0% and 4.4%) (P amp;lt; .001). Girls in all 3 countries had higher HbA1c and BMI-SDS than boys. Conclusions: Sharing data between diabetes registries and nations enables us to better understand differences in diabetes outcome between countries. In this particular comparison, pediatric patients with diabetes in Sweden were more often treated with insulin pump, had lower HbA1c levels and a higher rate of severe hypoglycemia. Patients in Austria and Germany used rapid acting insulin analogs more often and had a lower rate of ketoacidosis.

Place, publisher, year, edition, pages
WILEY, 2018
Keywords
adolescents; metabolic control; quality of care; quality registry; type 1 diabetes
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-147919 (URN)10.1111/pedi.12591 (DOI)000430921600025 ()28940551 (PubMedID)
Note

Funding Agencies|Swedish Association of Local Authorities and Regions (SALAR); German Center for Diabetes Research (DZD); European Foundation for the Study of Diabetes (EFSD); German Diabetes Association

Available from: 2018-05-23 Created: 2018-05-23 Last updated: 2019-05-02
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.
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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
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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
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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
Keywords
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
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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
Keywords
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
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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
Keywords
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: 2019-06-28
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
Keywords
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
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