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The importance of low HbA1c during childhood on glycaemic control in adulthood and the risk of late complications.

Authors
  • Samuelsson, Ulf1
  • Anderzen, Johan2
  • Åkesson, Karin1, 2
  • Hanberger, Lena3
  • 1 Division of Paediatrics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. , (Sweden)
  • 2 Department of Paediatrics, County Hospital Ryhov, Jönköping, Sweden. , (Sweden)
  • 3 Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. , (Sweden)
Type
Published Article
Journal
Acta Paediatrica
Publisher
Wiley (Blackwell Publishing)
Publication Date
Apr 01, 2021
Volume
110
Issue
4
Pages
1264–1272
Identifiers
DOI: 10.1111/apa.15591
PMID: 32978990
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To evaluate whether a very low glycated haemoglobin A (HbA1c) (<48 mmol/mol, 6.5%) during childhood compared to higher HbA1c values further decreases the risk for microvascular complications. Data were included from the 5116 patients with type 1 diabetes transferred from the Swedish paediatric diabetes quality registry to the Swedish National Diabetes Register (NDR), until 2014. All HbA1c values ever registered in the paediatric registry were used to divide patients into six groups based on the mean HbA1c. Values were compared with HbA1c registered in 2013 and 2014 in NDR, together with data on retinopathy, micro- and macroalbuminuria, age at onset and duration of diabetes. The group with lowest mean-HbA1c during childhood had also the lowest mean as young adults during 2013 and 2014. The most common complication as young adults was retinopathy. The proportion with macroalbuminuria was 3% in the lowest HbA1c group during childhood and 3.9% in the highest group, and lower in the groups in between. Microalbuminuria had the same pattern. Retinopathy increased with each HbA1c group. Children with the lowest HbA1c values had the lowest HbA1c values as adults. HbA1c was associated with retinopathy but the relationship with albuminuria was not obvious. © 2020 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

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