Glycaemic control in children with type 1 Diabetes Mellitus in Malta (2013 - 2014)

Abstract

Background: Suboptimal glycaemic control, measured by glycosylated haemoglobin (HbA1c), increases the risk for long-term complications in Type 1 diabetes mellitus (T1DM). Aims and objectives:  To calculate and compare glycaemic control in children with T1DM in Malta during the period 2013 to 2014.  To identify any need for changing way services are structured and delivered. Methods: An estimated 96% of all children with T1DM less than 16 years of age in Malta are cared for by the same paediatric diabetes team, based at the main state hospital. The average HbA1c of all measurements taken every 3 months by HbA1c analyser was calculated for each patient and these results were validated by annual laboratory measurement of HbA1c from venous samples. Results: Overall, 43.8% of participants in 2013 and 49.6% of participants in 2014 achieved an HbA1c target of < 7.5%. The mean HbA1c in 2013 was 7.69±0.16% and in 2014 7.67±0.17%. A higher proportion of patients in the younger age-group achieved an HbA1c target of <7.5%. The patients most likely to have a higher HbA1c were in the older age-groups. Conclusion: Glycaemic control achieved in Malta in children aged < 16 years with T1DM was stable over the two years analysed. Our data is comparable, or slightly better, to that achieved in other European countries. However, there is always room for improvement, as Swedish data have shown. Multidisciplinary team meetings could be one way to address those patients not achieving adequate control.