Introduction. It remains unclear howHbA1crecommendations influence metabolic control of paediatric patients with type 1 diabetes mellitus. To evaluate this we compared reportedHbA1cwith guideline thresholds.Materials and Methods. We searched systematically MEDLINE and EMBASE for studies reporting onHbA1cin children with T1DM and grouped them according to targetedHbA1cobtained from regional guidelines. We assessed the discrepancies in the metabolic control between these groups by comparing meanHbA1cextracted from each study and the differences between actual and targetedHbA1c.Results. We included 105 from 1365 searched studies. The median (IQR)HbA1cfor the study population was 8.30% (8.00%–8.70%) and was lower in “6.5%” than in “7.5%” as targetedHbA1clevel (8.20% (7.85%–8.57%) versus 8.40% (8.20%–8.80%);p=0.028). Median difference between actual and targetedHbA1cwas 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.;p<0.001).Conclusions. Our study indicates that the 7.5% threshold results inHbA1clevels 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.
Assessing Patient Satisfaction Following Sodium Glucose Co-Transporter 2 Inhibitor Treatment for Type 1 Diabetes Mellitus: A Prospective Study in Japan
