LONGITUDINAL PATTERNS OF GLYCEMIC CONTROL AND DIABETES CARE FROM DIAGNOSIS IN A POPULATION-BASED COHORT WITH TYPE-1 DIABETES

Glycosylated hemoglobin is an indicator of long-term glycemic control and a strong predictor of diabetic complications, This paper provides a comprehensive description of glycemic control (total glycosylated he moglobin (GHb)) up to 4.5 years duration of diabetes by age, duration, and sex in a population-based cohort (n = 507) aged less than 20 year s followed from diagnosis of Type 1 diabetes in Wisconsin during 1987- 1994. important aspects of demographics and diabetes care are describe d to allow comparison with other populations, Since large variations b etween laboratories are known to exist in the measurement of GHb, leve ls are also interpreted relative to the frequency of short-term compli cations, GHb increased after diagnosis, but leveled off after 2-3 year s, Peak GHb values occurred in the age group 12-15 years, The within-i ndividual standard deviation in GHb between tests, adjusted for age an d duration, was 1.6%, The mean GHb at last testing was 11.3%, with a s tandard deviation across individuals of 2.9%, The majority (74%) of in dividuals saw a diabetes specialist at least once. The mean number of insulin injections per day increased from 2.2 to 2.5 across the 4.5-ye ar duration, and the insulin dose increased from 0.6 to 0.9 units per day per kg body weight, Despite the quite satisfactory level of care, 38% of subjects had GHb levels associated with significant short-term complications.