ESPEYB25 13. Global Health for the Paediatric Endocrinologist Diabetes and Diabetes Technology (5 abstracts)
13.11. Treatment regimens and glycaemic outcomes in more than 100 000 children with type 1 diabetes (2013-22): a longitudinal analysis of data from paediatric diabetes registries
Zimmermann AT , Lanzinger S , Kummernes SJ , Lund-Blix NA , Holl RW , Fröhlich-Reiterer E , Maahs DM , Ebekozien O , Rompicherla S , Warner JT , Pons Perez S , Robinson H , Craig ME , Johnson S , Akesson K , Thorén A , Eeg-Olofsson K , Ranjan AG , Madsen M , Witsch M , Bratke H , Alonso GT , Sumnik Z , Neuman V , Cinek O , Skrivarhaug T & Svensson J
Lancet Diabetes Endocrinol. 2025 Jan;13(1):47-56. PMID: 39622257 doi: 10.1016/S2213-8587(24)00279-1Erratum in: Lancet Diabetes Endocrinol. 2025;13(4):e7. doi: 10.1016/S2213-8587(25)00032-4
Brief Summary: This large longitudinal study analyzed data on ~140,000 children (aged ≤18 years) with type 1 diabetes (T1D) across 8 national registries from the US, Australian, Europe and Great Britain and the SWEET initiative between 2013 and 2022. Glycaemic control improved significantly - mean HbA1c reduced from 8.2% to 7.6%, the proportion of children achieving target HbA1c <7% increased, while the proportion of children with HbA1c >9%, as well as rates of severe hypoglycaemia and diabetic ketoacidosis, decreased. These achievements coincided with marked increases in the use of diabetes technologies, such as continuous glucose monitoring (CGM) and insulin pumps (CSII).
This multinational study provides comprehensive real-world evidence of improved glycaemic outcomes and reduced acute metabolic complications among children with T1D over the past decade, advances largely driven by the growing adoption of diabetes technologies such as CGM and CSII, as well as the establishment of diabetes registries and the introduction of more stringent HbA1c targets. These findings underscore not only the clinical benefits of technology but also a broader evolution in paediatric diabetes care toward real-time, data-informed management.
However, despite this progress, a substantial proportion of children fail to meet ISPAD glycaemic targets, highlighting persistent challenges, including disparities in healthcare infrastructure and access to technology. The findings highlight the need for continued innovation, such as wider adoption of automated insulin delivery systems, and stronger support systems to help families and clinicians optimize care. Ultimately, this study reinforces the importance of sustained investment in diabetes technologies and the imperative to ensure equitable access worldwide, so that all children with T1D can benefit from modern advances in care. A significant limitation is the lack of registry data from low- and middle-income countries.
Volume 22
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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