Changes in HbA1c between 2011-2017 in Austria/Germany, Sweden, and the United States: A Lifespan Perspective
Author Block: ANASTASIA ALBANESE-O'NEILL, JULIA HERMANN, ANN-MARIE SVENSSON, KELLEE MILLER, KLEMENS RAILE, KARIN AKESSON, PETER CALHOUN, KATARINA EEG-OLOFSSON, DAVID M. MAAHS, REINHARD W. HOLL, RAGNAR HANAS,
Gainesville, FL, Gothenburg, Sweden, Tampa, FL, Berlin, Germany, Jönköping, Sweden, Göteborg, Sweden, Stanford, CA, Ulm, Germany, Uddevalla, Sweden
Mean HbA1c across the lifespan in 2017 and changes in mean HbA1c between 2011 and 2017 overall and by age cohorts were analyzed. In 2017 mean HbA1c for adults ≥45 years converged across registries; HbA1c levels for subjects <25 years were highest in the U.S. (Figure). Controlling for age, sex, and T1D duration, overall HbA1c increased in the U.S. between 2011 and 2017 (2011=8.02%, 2017=8.26%, p<.01); decreased in Sweden (8.06%, 7.74%, p<.01); and did not change in Austria/Germany (7.84%, 7.84%, p=.49).
Controlling for sex and T1D duration, mean HbA1c decreased between 2011 and 2017 in all age cohorts in Sweden (all p<.01).
In the U.S., HbA1c increased in subjects <45 years and ≥65 years (all p<.05) and did not change in subjects 45-<65 years (p=.06). In Austria/Germany, HbA1c decreased in subjects 13-<19 years (p<.01), did not change in subjects <13 years (p=.26) and 19-<25 years (p=.88), and increased in subjects ≥25 years (all p<.05). Further research is warranted to better understand causes of geographic disparities in glycemic control.
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