Table of Contents Author Guidelines Submit a Manuscript
Journal of Diabetes Research
Volume 2016 (2016), Article ID 5490258, 7 pages
http://dx.doi.org/10.1155/2016/5490258
Review Article

The Stricter the Better? The Relationship between Targeted HbA1c Values and Metabolic Control of Pediatric Type 1 Diabetes Mellitus

1Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Sporna 36/50, 91-738 Lodz, Poland
2Department of Pediatrics, Endocrinology and Diabetology, Medical University of Silesia, Medykow 16, 40-752 Katowice, Poland
3Cancer Research UK Clinical Trials Unit, School of Cancer Sciences, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK

Received 7 September 2015; Accepted 14 December 2015

Academic Editor: Francisco J. Ruperez

Copyright © 2016 Marcin Braun et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. It remains unclear how recommendations influence metabolic control of paediatric patients with type 1 diabetes mellitus. To evaluate this we compared reported with guideline thresholds. Materials and Methods. We searched systematically MEDLINE and EMBASE for studies reporting on in children with T1DM and grouped them according to targeted obtained from regional guidelines. We assessed the discrepancies in the metabolic control between these groups by comparing mean extracted from each study and the differences between actual and targeted . Results. We included 105 from 1365 searched studies. The median (IQR) for the study population was 8.30% (8.00%–8.70%) and was lower in “6.5%” than in “7.5%” as targeted level (8.20% (7.85%–8.57%) versus 8.40% (8.20%–8.80%); ). Median difference between actual and targeted was 1.20% (0.80%–1.70%) and was higher in “6.5%” than in “7.5%” (1.70% (1.30%–2.07%) versus 0.90% (0.70%–1.30%), resp.; ). Conclusions. Our study indicates that the 7.5% threshold results in levels being closer to the therapeutic goal, but the actual values are still higher than those observed in the “6.5%” group. A meta-analysis of raw data from national registries or a prospective study comparing both approaches is warranted as the next step to examine this subject further.