Adolescent girls with type 1 diabetes have worse glycemic control than adolescent boys, have a higher HbA1c at diagnosis and are more likely to experience complications, such as retinopathy, in adulthood, according to recent findings.
In summary, 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.
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Ulf Samuelsson, MD, PhD, of the department of clinical and experimental medicine at Linköping University in Sweden, and colleagues analyzed data from 4,239 adolescents and young adults with type 1 diabetes using data from the Swedish pediatric diabetes quality registry (SWE) and the Swedish National Diabetes Registry (NDR; 2,279 girls and women; mean age in SWE, 15 years; mean age in NDR, 25 years). Participants were divided by HbA1c into three groups: less than 7.4%; 7.4% to 9.3%; and more than 9.3%.
Researchers found a higher proportion of female patients in the highest HbA1c group during adolescence (P < .001), but not as young adults. In the group with the highest HbA1c values during adolescence and as adults, 51.7% were girls and women, in the group with low HbA1c values in both registries, 34.2% were girls and women (P < .001).
Women also had a higher mean HbA1c value at diagnosis than men (11.2% vs. 10.9%; P < .03) and a higher HbA1c during adolescence (8.5% vs. 8.2%; P < .03). Researchers observed no between-sex differences during adulthood (8.4% for both).
As adults, more women had retinopathy than men (57.7% vs. 53.4%; P < .05). There were no significant between-sex differences for microalbuminuria and macroalbuminuria.
“More focus on glycemic control in female patients is necessary, both in clinical practice and in research,” the researchers wrote. “There is also a need to improve early identification of patients at risk of poor metabolic control and consequently at risk of complications in early adulthood, as poor metabolic control during adolescence continues into adulthood.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
To compare metabolic control between males and females with type 1 diabetes during adolescence and as young adults, and relate it to microvascular complications.
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.
When dividing HbA1c values in three groups; < 7.4% (57 mmol/mol), 7.4 – 9.3% (57-78 mmol/mol) and >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<0.001. As adults, more females had retinopathy, p<0.05. Females had higher mean HbA1c values at diagnosis, 11.2 vs 10.9 % (99 vs. 96 mmol/mol), p<0.03, during adolescence, 8.5 vs. 8.2% (69 vs. 66 mmol/mol) p<0.01, but not as young adults.
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.