To evaluate whether glycemic control has improved among children and adolescents with T1D in Taiwan from 2000 to 2023 and to investigate variations by specific sociodemographic factors such as sex, age, and DKA status.
Key Findings:
HbA1c levels declined significantly over the study period (β = −0.037% per year, 95% CI −0.053 to −0.021, p < 0.001), with an overall decrease of approximately 0.84%.
Annual mean HbA1c decreased from 9.17% in 2000 to 7.99% in 2023.
Improvement in HbA1c levels varied significantly by sex, DKA status, and age group at diagnosis.
Adolescents (12–18 years) had the highest HbA1c levels but also the steepest rate of improvement (β = −0.084%/yr).
The proportion of HbA1c measurements below 7.0% increased (OR = 1.029 per year, 95% CI 1.011–1.047, p = 0.002).
Interpretation:
The study indicates a significant decline in HbA1c levels among pediatric and adolescent T1D patients in Taiwan, reflecting advancements in diabetes management, including the adoption of CGM and insulin analogues.
Limitations:
The study is observational and cannot isolate the specific contributions of individual advancements in diabetes management, which may confound the results.
The youngest age group (0–6 years) showed no significant improvement, indicating persistent challenges in achieving glycemic control.
Conclusion:
Despite overall improvements in HbA1c levels, persistent clinical challenges remain, particularly in the youngest and adolescent age groups, necessitating targeted interventions.
Although treatment advances have increased the 5-year relative survival rates across all age groups, including a 15% increase for adolescents and young adults ages 15 to 39 years, it varies widely for...
