{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T04:26:22Z","timestamp":1771647982067,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T00:00:00Z","timestamp":1569196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine factors influencing the success of treatment for type 1 diabetes, defined as HbA<jats:sub>1c<\/jats:sub> &lt;\u00a058 mmol\/mol (&lt;7.5%), in a large paediatric cohort under real\u2010life conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a monocentric observational study analysing the determinants of glycaemic outcome (sex, age, comorbidities, sociodemographic factors, diabetes technology) in an entire cohort of people with diabetes aged up to 21\u00a0years. Glycaemic outcome was defined as an individual's median HbA<jats:sub>1c<\/jats:sub> and the prevalence of acute complications over this period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 700 young people with type\u00a01 diabetes [age 13.6 years (range: 1.4\u201320.9\u00a0years); diabetes duration 5.8 years (range: 0.1\u201318.3\u00a0years)], 63% were using an insulin pump and 32% any type of continuous glucose monitoring. Mean HbA<jats:sub>1c<\/jats:sub> was 61\u00a0mmol\/mol [95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 60\u201362; 7.7%, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 7.5\u20137.8]. Some 63% of children aged &lt;\u00a012\u00a0years reached HbA<jats:sub>1c<\/jats:sub> (58 mmol\/mol (&lt;7.5%) compared with 43% of older participants. The prevalence of severe hypoglycaemia was 2.41 events and that of diabetic ketoacidosis 1.4 events per 100 person\u2010years. Neither type of insulin therapy nor use of continuous glucose monitoring, sex or comorbidity with coeliac disease or thyroiditis was significantly associated with glycaemic outcome. However, age, diabetes duration, having a father not born in Germany, psychiatric comorbidities and family structure were associated with HbA<jats:sub>1c<\/jats:sub>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Current technologies and a multidisciplinary team approach allow high numbers of children and adolescents to realize tight glycaemic control with a low prevalence of acute complications. However, age\u2010related challenges, sociodemographic factors and psychological comorbidities are barriers to achieving best possible glycaemic outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14130","type":"journal-article","created":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T16:32:28Z","timestamp":1568046748000},"page":"797-804","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Determinants of glycaemic outcome in the current practice of care for young people up to 21 years old with type 1 diabetes under real\u2010life conditions"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9563-3537","authenticated-orcid":false,"given":"O.","family":"Kordonouri","sequence":"first","affiliation":[{"name":"Diabetes Centre for Children and Adolescents Children's Hospital AUF DER BULT Hannover Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Lange","sequence":"additional","affiliation":[{"name":"Medical Psychology Hannover Medical School Hannover Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Biester","sequence":"additional","affiliation":[{"name":"Diabetes Centre for Children and Adolescents Children's Hospital AUF DER BULT Hannover Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Datz","sequence":"additional","affiliation":[{"name":"Diabetes Centre for Children and Adolescents Children's Hospital AUF DER BULT Hannover Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Kapitzke","sequence":"additional","affiliation":[{"name":"Diabetes Centre for Children and Adolescents Children's Hospital AUF DER BULT Hannover Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"von dem Berge","sequence":"additional","affiliation":[{"name":"Diabetes Centre for Children and Adolescents Children's Hospital AUF DER BULT Hannover Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Weiskorn","sequence":"additional","affiliation":[{"name":"Diabetes Centre for Children and Adolescents Children's Hospital AUF DER BULT Hannover Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Danne","sequence":"additional","affiliation":[{"name":"Diabetes Centre for Children and Adolescents Children's Hospital AUF DER BULT Hannover 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