Continuing improvement in metabolic control in Czech children with type 1 diabetes: data from the ČENDA registry (2013-2020)
Abstract
Introduction: Diabetes belongs to the most common chronic diseases in childhood. Web-based national longitudinal pediatric diabetes registry (ČENDA) was established in 2013 by the joint efforts of Czech centers of pediatric diabetes.
Since then, the ČENDA registry represents an important source of data on the course, control, therapy and complications of diabetes in children and adolescents. This paper summarizes trends in key parameters of diabetes control over the first 8 years of the ČENDA registry.
Results: In 2020, the register contained data from 3818 patients, i. e. approximately 90% of children with diabetes in the Czech Republic. The registry data shows a decreasing trend in HbA1c in children with Type 1 diabetes - the mean HbA1c dropped by 12 mmol/mol from 66.6 mmol/mol in 2013 to 54.7 mmol/mol in 2020 (p < 0.001).
This change was accompanied by a reduction in the incidence of acute diabetic complications. Main predictors associated with lower HbA1c were treatment using modern technologies (insulin pumps and continuous glucose monitors), male sex, and care provided at a large diabetes center.
Conclusion: The prognosis of Czech children with type 1 diabetes has significantly improved in recent years. The introduction of modern technologies into clinical practice and the establishment of the ČENDA registry have very likely contributed to this positive trend.