Secular trends in HbA1c levels among children and adolescents with type 1 diabetes
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By
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Jung Chou
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Chao-Hsu Lin
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Shih-Kai Kevin Lin
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Yann-Jinn Lee
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Chi-Yu Huang
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Yu-En Kao
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Jia-Cian Yu
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Wei-Hsin Ting
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May 28, 2026
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Clinical Scorecard: Trends Over Time in HbA1c Levels in Pediatric and Adolescent Patients with Type 1 Diabetes
At a Glance
| Category | Detail |
|---|
| Condition | Type 1 Diabetes (T1D) |
| Key Mechanisms | Advancements in medical nutrition therapy, insulin analogues, continuous glucose monitoring, and reimbursement policies. |
| Target Population | Children and adolescents with Type 1 Diabetes. |
| Care Setting | Pediatric hospitals in Taiwan. |
Key Highlights
- Significant decline in HbA1c levels over 23 years (from 9.17% in 2000 to 7.99% in 2023).
- Improvement in HbA1c levels varied by sex, DKA status, and age group at diagnosis.
- Adolescents (12-18 years) had the highest HbA1c levels but showed the steepest improvement.
- The proportion of patients achieving HbA1c <7.0% increased significantly over time.
- Youngest age group (0-6 years) showed no significant improvement in HbA1c levels.
Guideline-Based Recommendations
Diagnosis
- Assess glycemic control primarily through HbA1c levels.
Management
- Target HbA1c <53 mmol/mol (<7.0%) for children and adolescents.
Monitoring & Follow-up
- Regular monitoring of HbA1c levels to optimize diabetes management.
Risks
- Higher HbA1c levels are associated with increased risk of complications such as end-stage renal disease, retinopathy, and neuropathy.
Patient & Prescribing Data
688 pediatric and adolescent patients with Type 1 Diabetes.
Improvements in glycemic control correlated with the adoption of diabetes technologies and policy changes.
Clinical Best Practices
- Utilize continuous glucose monitoring to enhance glycemic control.
- Implement individualized treatment plans considering age, sex, and DKA status.
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