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Erschienen in: Acta Diabetologica 7/2017

18.04.2017 | Original Article

Achievement of metabolic control among children and adolescents with type 1 diabetes in Spain

verfasst von: Itxaso Rica, Andrés Mingorance, Ana Lucía Gómez-Gila, María Clemente, Isabel González, María Caimari, Beatriz García-Cuartero, Raquel Barrio

Erschienen in: Acta Diabetologica | Ausgabe 7/2017

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Abstract

Aims

To assess metabolic control in a paediatric T1D population in Spain and analyse the rate of severe acute decompensations and chronic complications.

Methods

Data from patients treated at eight paediatric diabetes units with experienced diabetes teams between June and December 2014 were analysed in an observational prospective study. Variables included: age, sex, diabetes duration, number of follow-up visits/year, anthropometrical data, insulin treatment modalities, mean annual HbA1c and the prevalence of acute and chronic complications. SPSS statistics 21.0 was used.

Results

A total of 853 patients (49.7% female) with a mean age of 12.1 ± 3.7 years were included. Anthropometric data were normal. Mean diabetes duration was 8 ± 3.4 years. Mean outpatient follow-up was 4.7 ± 0.04 visits/year. Twenty-five per cent were on continuous subcutaneous insulin infusion (CSII). Mean HbA1c was 7.3 ± 1% (56 ± 8 mmol/mol) and 66.6% had HbA1c < 7.5% (58 mmol/mol). HbA1c value correlated negatively with age at onset and positively with years of diabetes, number of visits/year and current age (F = 7.06; p = 0.01). Patients on CSII (n = 213) were younger, attended the outpatient clinic more frequently, were diagnosed earlier, had better metabolic control and had presented more severe hypoglycaemic episodes the previous year. The rate of severe decompensation (episodes/100 patients/year) was ketoacidosis 1.5 and severe hypoglycaemia 4.5. The prevalence of chronic complications was very low.

Conclusions

Our data describe the good compliance of paediatric T1D patients treated at eight paediatric units in Spain following international standards of metabolic control.
Literatur
1.
Zurück zum Zitat The Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329:977–986CrossRef The Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329:977–986CrossRef
2.
Zurück zum Zitat Nathan DM, Cleary PA, Backlund JY et al (2005) Diabetes control and complications trial/epidemiology of diabetes interventions and complications (DCCT/EDIC) study research group: intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med 353:2643–2653CrossRefPubMed Nathan DM, Cleary PA, Backlund JY et al (2005) Diabetes control and complications trial/epidemiology of diabetes interventions and complications (DCCT/EDIC) study research group: intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med 353:2643–2653CrossRefPubMed
3.
Zurück zum Zitat Writing Team for the Diabetes Control and Complications Trial/epidemiology of diabetes interventions and complications research group (2003) Sustained effect of intensive treatment of type 1 diabetes mellitus on development and progression of diabetic nephropathy: the epidemiology of diabetes interventions and complications (EDIC) study. JAMA 290:2159–2167CrossRef Writing Team for the Diabetes Control and Complications Trial/epidemiology of diabetes interventions and complications research group (2003) Sustained effect of intensive treatment of type 1 diabetes mellitus on development and progression of diabetic nephropathy: the epidemiology of diabetes interventions and complications (EDIC) study. JAMA 290:2159–2167CrossRef
4.
Zurück zum Zitat Petitti DB, Klingensmith GJ, Bell RA et al (2009) Glycaemic control in youth with diabetes: the SEARCH for diabetes in Youth Study. J Pediatr 155:668–672CrossRefPubMedPubMedCentral Petitti DB, Klingensmith GJ, Bell RA et al (2009) Glycaemic control in youth with diabetes: the SEARCH for diabetes in Youth Study. J Pediatr 155:668–672CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Tansey M, Beck R, Ruedy K et al (2016) Persistently high glucose levels in young children with type 1 diabetes. Pediatr Diabetes 17:93–100CrossRefPubMed Tansey M, Beck R, Ruedy K et al (2016) Persistently high glucose levels in young children with type 1 diabetes. Pediatr Diabetes 17:93–100CrossRefPubMed
6.
Zurück zum Zitat Zuijdwijk CS, Cuerden M, Mahmud FH (2013) Social determinants of health on glycaemic control in paediatric type 1 diabetes. J Pediatr 162:730–735CrossRefPubMed Zuijdwijk CS, Cuerden M, Mahmud FH (2013) Social determinants of health on glycaemic control in paediatric type 1 diabetes. J Pediatr 162:730–735CrossRefPubMed
7.
Zurück zum Zitat Nimri R, Weintrob N, Benzaquen H, Ofan R, Fayman G, Phillip M (2006) Insulin pump therapy in youth with type 1 diabetes: a retrospective paired study. Pediatrics 117:2126–2131CrossRefPubMed Nimri R, Weintrob N, Benzaquen H, Ofan R, Fayman G, Phillip M (2006) Insulin pump therapy in youth with type 1 diabetes: a retrospective paired study. Pediatrics 117:2126–2131CrossRefPubMed
8.
Zurück zum Zitat Doyle EA, Weinzimer SA, Steffen AT, Ahern JAH, Vincent M, Tamborlane WVA (2004) A randomized, prospective trial comparing the efficacy of continuous subcutaneous insulin infusion with multiple daily injections using insulin glargine. Diabetes Care 27:1554–1558CrossRefPubMed Doyle EA, Weinzimer SA, Steffen AT, Ahern JAH, Vincent M, Tamborlane WVA (2004) A randomized, prospective trial comparing the efficacy of continuous subcutaneous insulin infusion with multiple daily injections using insulin glargine. Diabetes Care 27:1554–1558CrossRefPubMed
9.
Zurück zum Zitat American Diabetes Association (2016) Children and adolescents. Sec. 11. In Standards of medical care in diabetes. Diabetes Care 39(Suppl. 1):S86–S93 American Diabetes Association (2016) Children and adolescents. Sec. 11. In Standards of medical care in diabetes. Diabetes Care 39(Suppl. 1):S86–S93
10.
Zurück zum Zitat Rewers MJ, Pillay K, de Beaufort C et al (2014) Assessment and monitoring of glycemic control in children and adolescents with diabetes. ISPAD clinical practice consensus guidelines compendium. Pediatr Diabetes 15(Suppl. 20):102–114CrossRefPubMed Rewers MJ, Pillay K, de Beaufort C et al (2014) Assessment and monitoring of glycemic control in children and adolescents with diabetes. ISPAD clinical practice consensus guidelines compendium. Pediatr Diabetes 15(Suppl. 20):102–114CrossRefPubMed
11.
Zurück zum Zitat Miller KM, Foster NC, Beck RW et al (2015) Current state of type 1 diabetes treatment in the U.S.: Updated data from the T1D exchange clinic registry. Diabetes Care 38:971–978CrossRefPubMed Miller KM, Foster NC, Beck RW et al (2015) Current state of type 1 diabetes treatment in the U.S.: Updated data from the T1D exchange clinic registry. Diabetes Care 38:971–978CrossRefPubMed
12.
Zurück zum Zitat Wolfsdorf JI, Allgrove J, Craig ME et al (2014) A consensus statement from the international society for pediatric and adolescent diabetes: diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes 15(Suppl. 20):154–179CrossRefPubMed Wolfsdorf JI, Allgrove J, Craig ME et al (2014) A consensus statement from the international society for pediatric and adolescent diabetes: diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes 15(Suppl. 20):154–179CrossRefPubMed
13.
Zurück zum Zitat Ly TT, Maahs DM, Rewers A, Dunger D, Oduwole A, Jones TW (2014) ISPAD Clinical Practice Consensus Guidelines—Hypoglycemia: assessment and management of hypoglycemia in children and adolescents with diabetes. Pediatric Diabetes 15(Suppl. 20):180–192CrossRefPubMed Ly TT, Maahs DM, Rewers A, Dunger D, Oduwole A, Jones TW (2014) ISPAD Clinical Practice Consensus Guidelines—Hypoglycemia: assessment and management of hypoglycemia in children and adolescents with diabetes. Pediatric Diabetes 15(Suppl. 20):180–192CrossRefPubMed
14.
Zurück zum Zitat Campbell MS, Schatz DA, Chen V et al (2014) A contrast between children and adolescents with excellent and poor control: the T1D exchange clinic registry experience. Pediatr Diabetes 15:110–117CrossRefPubMed Campbell MS, Schatz DA, Chen V et al (2014) A contrast between children and adolescents with excellent and poor control: the T1D exchange clinic registry experience. Pediatr Diabetes 15:110–117CrossRefPubMed
15.
Zurück zum Zitat Downie E, Craig ME, Hing S, Cusumano J, Chan A, Donaghue KC (2011) Continued reduction in the prevalence of retinopathy in adolescents with type 1 diabetes: role of insulin therapy and glycemic control. Diabetes Care 34:2368–2373CrossRefPubMedPubMedCentral Downie E, Craig ME, Hing S, Cusumano J, Chan A, Donaghue KC (2011) Continued reduction in the prevalence of retinopathy in adolescents with type 1 diabetes: role of insulin therapy and glycemic control. Diabetes Care 34:2368–2373CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat DCCT Research Group (Diabetes Control and Complications Trial Research Group) (1994) Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: diabetes control and complications trial. J Pediatr 125:177–188CrossRef DCCT Research Group (Diabetes Control and Complications Trial Research Group) (1994) Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: diabetes control and complications trial. J Pediatr 125:177–188CrossRef
17.
Zurück zum Zitat White NH, Sun W, Cleary PA et al (2010) Effect of prior intensive therapy in type 1 diabetes on 10-year progression of retinopathy in the DCCT/EDIC: comparison of adults and adolescents. Diabetes 59:1244–1253CrossRefPubMedPubMedCentral White NH, Sun W, Cleary PA et al (2010) Effect of prior intensive therapy in type 1 diabetes on 10-year progression of retinopathy in the DCCT/EDIC: comparison of adults and adolescents. Diabetes 59:1244–1253CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Wong TY, Cheng CY, Sabanayagam C (2014) Kidney and eye diseases: common risk factors, etiological mechanisms, and pathways. Kidney Int 85:1290–1302CrossRefPubMed Wong TY, Cheng CY, Sabanayagam C (2014) Kidney and eye diseases: common risk factors, etiological mechanisms, and pathways. Kidney Int 85:1290–1302CrossRefPubMed
19.
Zurück zum Zitat Marcovecchio ML, Dalton RN, Schwarze CP et al (2009) Ambulatory blood pressure measurements are related to albumin excretion and are predictive for risk of microalbuminuria in Young people with type 1 diabetes. Diabetologia 52:1173–1181CrossRefPubMed Marcovecchio ML, Dalton RN, Schwarze CP et al (2009) Ambulatory blood pressure measurements are related to albumin excretion and are predictive for risk of microalbuminuria in Young people with type 1 diabetes. Diabetologia 52:1173–1181CrossRefPubMed
20.
Zurück zum Zitat Gallego PH, Craig ME, Hing S, Donaghue KC (2008) Role of blood pressure in development of early retinopathy in adolescents with type 1 diabetes: prospective cohort study. BMJ 337:a918CrossRefPubMedPubMedCentral Gallego PH, Craig ME, Hing S, Donaghue KC (2008) Role of blood pressure in development of early retinopathy in adolescents with type 1 diabetes: prospective cohort study. BMJ 337:a918CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Hansson L, Zanchetti A, Carruthers SG et al (1998) Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the hypertension optimal treatment (HOT) randomised trial. HOT Study Group. Lancet 351:1755–1762CrossRefPubMed Hansson L, Zanchetti A, Carruthers SG et al (1998) Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the hypertension optimal treatment (HOT) randomised trial. HOT Study Group. Lancet 351:1755–1762CrossRefPubMed
22.
Zurück zum Zitat De Block CE, De Leeuw IH, Van Gaal LF (2005) Impact of overweight on chronic microvascular complications in type 1 diabetic patients. Diabetes Care 28:1649–1655CrossRefPubMed De Block CE, De Leeuw IH, Van Gaal LF (2005) Impact of overweight on chronic microvascular complications in type 1 diabetic patients. Diabetes Care 28:1649–1655CrossRefPubMed
23.
Zurück zum Zitat Donaghue KC, Wadwa RP, Dimeglio LA et al (2014) Microvascular and macrovascular complications in children and adolescents. Pediatric Diabetes 15(Suppl. 20):257–269CrossRefPubMed Donaghue KC, Wadwa RP, Dimeglio LA et al (2014) Microvascular and macrovascular complications in children and adolescents. Pediatric Diabetes 15(Suppl. 20):257–269CrossRefPubMed
24.
Zurück zum Zitat de Beaufort C, Vazeou A, Sumnik Z et al (2012) Harmonize care to optimize outcome in children and adolescents with diabetes mellitus: treatment recommendations in Europe. Pediatr Diabetes 13 (Suppl. 16):15–19). Version of record online: 29 AUG 2012. doi: 10.1111/j.1399-5448.2012.00908 de Beaufort C, Vazeou A, Sumnik Z et al (2012) Harmonize care to optimize outcome in children and adolescents with diabetes mellitus: treatment recommendations in Europe. Pediatr Diabetes 13 (Suppl. 16):15–19). Version of record online: 29 AUG 2012. doi: 10.​1111/​j.​1399-5448.​2012.​00908
25.
Zurück zum Zitat Carrascosa A, Fernández JM, Fernández C et al (2008) Estudio transversal español de crecimiento 2008. Parte II: valores de talla, peso e índice de masa corporal desde el nacimiento a la talla adulta. Anal Pediatr 68(6):552–569CrossRef Carrascosa A, Fernández JM, Fernández C et al (2008) Estudio transversal español de crecimiento 2008. Parte II: valores de talla, peso e índice de masa corporal desde el nacimiento a la talla adulta. Anal Pediatr 68(6):552–569CrossRef
26.
Zurück zum Zitat de Man SA, Andre JL, Bachmann H et al (1991) Blood pressure in childhood: pooled findings of six European studies. J Hypertens 9:109–114CrossRefPubMed de Man SA, Andre JL, Bachmann H et al (1991) Blood pressure in childhood: pooled findings of six European studies. J Hypertens 9:109–114CrossRefPubMed
27.
Zurück zum Zitat Wood JR, Miller KM, Maahs DM et al (2013) Most youth with type 1 diabetes in the T1D exchange clinic registry do not meet American diabetes association or international society for pediatric and adolescent diabetes clinical guidelines. Diabetes Care 36:2035–2037CrossRefPubMedPubMedCentral Wood JR, Miller KM, Maahs DM et al (2013) Most youth with type 1 diabetes in the T1D exchange clinic registry do not meet American diabetes association or international society for pediatric and adolescent diabetes clinical guidelines. Diabetes Care 36:2035–2037CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat The Information Centre, National Diabetes Audit (2008) Key findings about the quality of care for children and young people with diabetes in England and Wales. In: Report for the audit period 2007. The Information Centre The Information Centre, National Diabetes Audit (2008) Key findings about the quality of care for children and young people with diabetes in England and Wales. In: Report for the audit period 2007. The Information Centre
30.
Zurück zum Zitat Maahs DM, Hermann JM, BuBose SN et al (2014) Contrasting the clinical care and outcomes of 2622 children with type 1 diabetes less than 6 years of age in the United States T1D Exchange and German/Australian DPV registries. Diabetologia 57(8):1578–1585CrossRefPubMed Maahs DM, Hermann JM, BuBose SN et al (2014) Contrasting the clinical care and outcomes of 2622 children with type 1 diabetes less than 6 years of age in the United States T1D Exchange and German/Australian DPV registries. Diabetologia 57(8):1578–1585CrossRefPubMed
31.
Zurück zum Zitat Enes P, Martín-Frías M, Álvarez MAA, Yelmo R, Alonso M, Barrio R (2015) Achievement of metabolic control goals set by the American diabetes association and the international society for pediatric and adolescent diabetes in pediatric patients with type 1 diabetes from Spain. Diabetes Res Clin Pract 107:300–305CrossRefPubMed Enes P, Martín-Frías M, Álvarez MAA, Yelmo R, Alonso M, Barrio R (2015) Achievement of metabolic control goals set by the American diabetes association and the international society for pediatric and adolescent diabetes in pediatric patients with type 1 diabetes from Spain. Diabetes Res Clin Pract 107:300–305CrossRefPubMed
32.
Zurück zum Zitat Rewers A, Chase HP, Mackenzie T et al (2002) Predictors of acute complications in children with type 1 diabetes. JAMA 287:2511–2518CrossRefPubMed Rewers A, Chase HP, Mackenzie T et al (2002) Predictors of acute complications in children with type 1 diabetes. JAMA 287:2511–2518CrossRefPubMed
33.
Zurück zum Zitat Fritsch M, Rosenbauer J, Schober E, Neu A, Placzek K, Holl RW (2011) Predictors of diabetic ketoacidosis in children and adolescents with type 1 diabetes. Experience from a large multicentre database. Pediatr Diabetes 12:307–312CrossRefPubMed Fritsch M, Rosenbauer J, Schober E, Neu A, Placzek K, Holl RW (2011) Predictors of diabetic ketoacidosis in children and adolescents with type 1 diabetes. Experience from a large multicentre database. Pediatr Diabetes 12:307–312CrossRefPubMed
34.
Zurück zum Zitat Bulsara MK, Holman CD, Davis EA, Jones TW (2004) The impact of a decade of changing treatment on rates of severe hypoglycemia in a population-based cohort of children with type 1 diabetes. Diabetes Care 27:2293–2298CrossRefPubMed Bulsara MK, Holman CD, Davis EA, Jones TW (2004) The impact of a decade of changing treatment on rates of severe hypoglycemia in a population-based cohort of children with type 1 diabetes. Diabetes Care 27:2293–2298CrossRefPubMed
35.
Zurück zum Zitat Mortensen HB, Hougaard P (1997) Comparison of metabolic control in a cross-sectional study of 2873 children and adolescents with IDDM from 18 countries. The Hvidøre Study Group on Childhood Diabetes. Diabetes Care 20:714–720CrossRefPubMed Mortensen HB, Hougaard P (1997) Comparison of metabolic control in a cross-sectional study of 2873 children and adolescents with IDDM from 18 countries. The Hvidøre Study Group on Childhood Diabetes. Diabetes Care 20:714–720CrossRefPubMed
36.
Zurück zum Zitat Rosenbauer J, Dost A, Karges B, Hungele A, Stahl A, Bächle Ch et al (2012) Improved metabolic control in children and adolescents with type 1 diabetes a trend analysis using prospective multicenter data from Germany and Austria. Diabetes Care 35:80–86CrossRefPubMed Rosenbauer J, Dost A, Karges B, Hungele A, Stahl A, Bächle Ch et al (2012) Improved metabolic control in children and adolescents with type 1 diabetes a trend analysis using prospective multicenter data from Germany and Austria. Diabetes Care 35:80–86CrossRefPubMed
37.
Zurück zum Zitat Rosilio M, Cotton JB, Wieliczko MC et al (1998) Factors associated with glycemic control. A cross-sectional nationwide study in 2579 French children with type 1 diabetes. French Pediatric Diabetes Group. Diabetes Care 21:1146–1153CrossRefPubMed Rosilio M, Cotton JB, Wieliczko MC et al (1998) Factors associated with glycemic control. A cross-sectional nationwide study in 2579 French children with type 1 diabetes. French Pediatric Diabetes Group. Diabetes Care 21:1146–1153CrossRefPubMed
38.
Zurück zum Zitat O’Connell SM, Cooper MN, Bulsara MK, Davis EA, Jones TW (2011) Reducing rates of severe hypoglycemia in a population-based cohort of children and adolescents with type 1 diabetes over the decade 2000–2009. Diabetes Care 34:2379–2380CrossRefPubMedPubMedCentral O’Connell SM, Cooper MN, Bulsara MK, Davis EA, Jones TW (2011) Reducing rates of severe hypoglycemia in a population-based cohort of children and adolescents with type 1 diabetes over the decade 2000–2009. Diabetes Care 34:2379–2380CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Cengiz E, Xing D, Wong JC et al (2013) Severe hypoglycemia and diabetic ketoacidosis among youth with type 1 diabetes in the T1D exchange clinic registry. Pediatr Diabetes 14:447–454CrossRefPubMedPubMedCentral Cengiz E, Xing D, Wong JC et al (2013) Severe hypoglycemia and diabetic ketoacidosis among youth with type 1 diabetes in the T1D exchange clinic registry. Pediatr Diabetes 14:447–454CrossRefPubMedPubMedCentral
40.
Zurück zum Zitat Yeh HC, Brown TT, Maruthur N et al (2012) Comparative effectiveness and safety of methods of insulin delivery and glucose monitoring for diabetes mellitus: a systematic review and meta-analysis. Ann Intern Med 157:336–347CrossRefPubMed Yeh HC, Brown TT, Maruthur N et al (2012) Comparative effectiveness and safety of methods of insulin delivery and glucose monitoring for diabetes mellitus: a systematic review and meta-analysis. Ann Intern Med 157:336–347CrossRefPubMed
41.
Zurück zum Zitat Cho YH, Craig ME, Donaghue KC (2014) Puberty as an accelerator for diabetes complications. Pediatr Diabetes 15:18–26CrossRefPubMed Cho YH, Craig ME, Donaghue KC (2014) Puberty as an accelerator for diabetes complications. Pediatr Diabetes 15:18–26CrossRefPubMed
42.
Zurück zum Zitat Herbst A, Kordonouri O, Schwab KO, Schmidt F, Holl RW, DPV Initiative of the German Working Group for Pediatric Diabetology Germany (2007) Impact of physical activity on cardiovascular risk factors in children with type 1 diabetes: a multicenter study of 23,251 patients. Diabetes Care 30:2098–2100CrossRefPubMed Herbst A, Kordonouri O, Schwab KO, Schmidt F, Holl RW, DPV Initiative of the German Working Group for Pediatric Diabetology Germany (2007) Impact of physical activity on cardiovascular risk factors in children with type 1 diabetes: a multicenter study of 23,251 patients. Diabetes Care 30:2098–2100CrossRefPubMed
43.
Zurück zum Zitat Edge JA, James T, Shine B (2008) Longitudinal screening of serum lipids in children and adolescents with type 1 diabetes in a UK clinic population. Diabet Med 25:942–948CrossRefPubMed Edge JA, James T, Shine B (2008) Longitudinal screening of serum lipids in children and adolescents with type 1 diabetes in a UK clinic population. Diabet Med 25:942–948CrossRefPubMed
44.
Zurück zum Zitat Cho YH, Craig ME, Hing S et al (2011) Microvascular complications assessment in adolescents with 2- to 5-yr duration of type 1 diabetes from 1990 to 2006. Pediatr Diabetes 12:682–689CrossRefPubMed Cho YH, Craig ME, Hing S et al (2011) Microvascular complications assessment in adolescents with 2- to 5-yr duration of type 1 diabetes from 1990 to 2006. Pediatr Diabetes 12:682–689CrossRefPubMed
45.
Zurück zum Zitat Schultz CJ, Konopelska-Bahu T, Dalton RN et al (1999) Oxford Regional Prospective Study Group. Microalbuminuria prevalence varies with age, sex, and puberty in children with type 1 diabetes followed from diagnosis in a longitudinal study. Diabetes Care 22:495–502CrossRefPubMed Schultz CJ, Konopelska-Bahu T, Dalton RN et al (1999) Oxford Regional Prospective Study Group. Microalbuminuria prevalence varies with age, sex, and puberty in children with type 1 diabetes followed from diagnosis in a longitudinal study. Diabetes Care 22:495–502CrossRefPubMed
46.
Zurück zum Zitat Amin R, Widmer B, Prevost AT et al (2008) Risk of microalbuminuria and progression to macroalbuminuria in a cohort with childhood onset type 1 diabetes: prospective observational study. BMJ 336:697–701CrossRefPubMedPubMedCentral Amin R, Widmer B, Prevost AT et al (2008) Risk of microalbuminuria and progression to macroalbuminuria in a cohort with childhood onset type 1 diabetes: prospective observational study. BMJ 336:697–701CrossRefPubMedPubMedCentral
47.
Zurück zum Zitat American Diabetes Association (2016) Microvascular complications and foot care. Sec. 9. In Standards of medical care in diabetes. Diabetes Care 39(Suppl. 1):S72–S80 American Diabetes Association (2016) Microvascular complications and foot care. Sec. 9. In Standards of medical care in diabetes. Diabetes Care 39(Suppl. 1):S72–S80
Metadaten
Titel
Achievement of metabolic control among children and adolescents with type 1 diabetes in Spain
verfasst von
Itxaso Rica
Andrés Mingorance
Ana Lucía Gómez-Gila
María Clemente
Isabel González
María Caimari
Beatriz García-Cuartero
Raquel Barrio
Publikationsdatum
18.04.2017
Verlag
Springer Milan
Erschienen in
Acta Diabetologica / Ausgabe 7/2017
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-017-0991-0

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