Target setting in intensive insulin management is associated with metabolic control: The Hvidoere Childhood Diabetes Study Group Centre Differences Study 2005

Swift, P. G. F.; Skinner, T. C.; De Beaufort, Carine; Cameron, F. J.; Åman, J.; Aanstoot, H.-J.; Castaño, L.; Chiarelli, F.; Daneman, D.; Danne, T.; Dorchy, H.; Hoey, H.; Kaprio, E. A.; Kaufman, F.; Kocova, M.; Mortensen, H. B.; Njølstad, P. R.; Phillip, M.; Robertson, K. J.; Schoenle, E. J.; Urakami, T.; Vanelli, M.; Ackermann, R. W.; Skovlund, S. E.

doi:10.1111/j.1399-5448.2009.00596.x

Reference : Target setting in intensive insulin management is associated with metabolic control: ...


	Document type :	Scientific journals : Article
	Discipline(s) :	Human health sciences : Multidisciplinary, general & others
	To cite this reference:	http://hdl.handle.net/10993/27183

Title :	Target setting in intensive insulin management is associated with metabolic control: The Hvidoere Childhood Diabetes Study Group Centre Differences Study 2005
Language :	English
Author, co-author :	Swift, P. G. F. [Children's Hospital, Leicester Royal Infirmary, United Kingdom]
	Skinner, T. C. [Combined Universities Centre for Rural Health, Geraldton Western, Australia]
	De Beaufort, Carine [University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB) >]
	Cameron, F. J. [Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Australia]
	Åman, J. [Barn-och ungdomskliniken, Universitetssjukhuset Södra Grev Rosengatan, Sweden]
	Aanstoot, H.-J. [Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, Netherlands]
	Castaño, L. [Endocrinology and Diabetes Research Group, Hospital de Cruces, Ciberdem, Spain]
	Chiarelli, F. [Department of Paediatrics, University of Chieti, Chieti, Italy]
	Daneman, D. [The Hospital for Sick Children University, Toronto, Canada]
	Danne, T. [Kinderkrankenhaus auf der Bult, Hannover, Germany]
	Dorchy, H. [Hôpital Universitaire des Enfants Reine Fabiola Diabetology Clinic, Brussels, Belgium]
	Hoey, H. [Department of Paediatrics, Trinity College, National Children's Hospital, Dublin, Ireland]
	Kaprio, E. A. [Peijas Hospital, Vantaa, Finland]
	Kaufman, F. [Children's Hospital of Los Angeles, United States]
	Kocova, M. [Medical Faculty, Department of Endocrinology and Genetics, Pediatric Clinic Republic, Macedonia]
	Mortensen, H. B. [Department of Paediatrics, Glostrup University Hospital, Denmark]
	Njølstad, P. R. [Department of Pediatrics, Haukeland University Hospital, Norway, Department of Clinical Medicine, University of Bergen, Norway]
	Phillip, M. [National Center of Childhood Diabetes, Schneider Children's Medical Center, Petah Tikva, Israel]
	Robertson, K. J. [Royal Hospital for Sick Children Glasgow, Scotland, United Kingdom]
	Schoenle, E. J. [University Childrens Hospital, Zurich, Switzerland]
	Urakami, T. [Department of Paediatrics, Nihon University School of Medicine, Tokyo, Japan]
	Vanelli, M. [Centro di Diabetologia, University of Parma, Italy]
	Ackermann, R. W. [Novo Nordisk A/S, Bagsvaerd, Denmark]
	Skovlund, S. E. [Novo Nordisk A/S, Bagsvaerd, Denmark]
Publication date :	2010
Journal title :	Pediatric Diabetes
Volume :	11
Issue/season :	4
Pages :	271-278
Peer reviewed :	Yes
ISSN :	1399543X
Keywords :	[en] Adolescence ; Centre differences ; Glycaemic control ; Targets ; Adolescent ; Blood Glucose ; Child ; Cross-Sectional Studies ; Diabetes Mellitus ; Female ; Hemoglobin A, Glycosylated ; Humans ; Hypoglycemic Agents ; Insulin ; Male ; Parents ; Practice Guidelines as Topic ; Treatment Outcome
Abstract :	[en] Objective: To evaluate glycaemic targets set by diabetes teams, their perception by adolescents and parents, and their influence on metabolic control.Methods: Clinical data and questionnaires were completed by adolescents, parents/carers and diabetes teams in 21 international centres. HbA1c was measured centrally.Results: A total of 2062 adolescents completed questionnaires (age 14.4 ± 2.3 yr; diabetes duration 6.1 ± 3.5 yr). Mean HbA 1c = 8.2 ± 1.4% with significant differences between centres (F = 12.3; p < 0.001) range from 7.4 to 9.1%. There was a significant correlation between parent (r = 0.20) and adolescent (r = 0.21) reports of their perceived ideal HbA1c and their actual HbA1c result (p < 0.001), and a stronger association between parents' (r = 0.39) and adolescents' (r = 0.4) reports of the HbA1c they would be happy with and their actual HbA1c result. There were significant differences between centres on parent and adolescent reports of ideal and happy with HbA1c (8.1 < F > 17.4;p < 0.001). A lower target HbA1c and greater consistency between members of teams within centres were associated with lower centre HbA1c (F = 16.0; df = 15; p < 0.001).Conclusions: Clear and consistent setting of glycaemic targets by diabetes teams is strongly associated with HbA1c outcome in adolescents. Target setting appears to play a significant role in explaining the differences in metabolic outcomes between centres. © 2009 John Wiley & Sons A/S.
Permalink :	http://hdl.handle.net/10993/27183
DOI :	10.1111/j.1399-5448.2009.00596.x

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