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• W2222870303 abstract "Introduction . It remains unclear how<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M1><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=normal>H</mml:mi><mml:mi mathvariant=normal>b</mml:mi><mml:mi mathvariant=normal>A</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant=normal>1</mml:mn><mml:mi mathvariant=normal>c</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math>recommendations influence metabolic control of paediatric patients with type 1 diabetes mellitus. To evaluate this we compared reported<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M2><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=normal>H</mml:mi><mml:mi mathvariant=normal>b</mml:mi><mml:mi mathvariant=normal>A</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant=normal>1</mml:mn><mml:mi mathvariant=normal>c</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math>with guideline thresholds. Materials and Methods . We searched systematically MEDLINE and EMBASE for studies reporting on<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M3><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=normal>H</mml:mi><mml:mi mathvariant=normal>b</mml:mi><mml:mi mathvariant=normal>A</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant=normal>1</mml:mn><mml:mi mathvariant=normal>c</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math>in children with T1DM and grouped them according to targeted<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M4><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=normal>H</mml:mi><mml:mi mathvariant=normal>b</mml:mi><mml:mi mathvariant=normal>A</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant=normal>1</mml:mn><mml:mi mathvariant=normal>c</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math>obtained from regional guidelines. We assessed the discrepancies in the metabolic control between these groups by comparing mean<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M5><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=normal>H</mml:mi><mml:mi mathvariant=normal>b</mml:mi><mml:mi mathvariant=normal>A</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant=normal>1</mml:mn><mml:mi mathvariant=normal>c</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math>extracted from each study and the differences between actual and targeted<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M6><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=normal>H</mml:mi><mml:mi mathvariant=normal>b</mml:mi><mml:mi mathvariant=normal>A</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant=normal>1</mml:mn><mml:mi mathvariant=normal>c</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math>. Results . We included 105 from 1365 searched studies. The median (IQR)<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M7><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=normal>H</mml:mi><mml:mi mathvariant=normal>b</mml:mi><mml:mi mathvariant=normal>A</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant=normal>1</mml:mn><mml:mi mathvariant=normal>c</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math>for the study population was 8.30% (8.00%–8.70%) and was lower in “6.5%” than in “7.5%” as targeted<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M8><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=normal>H</mml:mi><mml:mi mathvariant=normal>b</mml:mi><mml:mi mathvariant=normal>A</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant=normal>1</mml:mn><mml:mi mathvariant=normal>c</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math>level (8.20% (7.85%–8.57%) versus 8.40% (8.20%–8.80%);<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M9><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle=italic>0.028</mml:mn></mml:math>). Median difference between actual and targeted<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M10><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=normal>H</mml:mi><mml:mi mathvariant=normal>b</mml:mi><mml:mi mathvariant=normal>A</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant=normal>1</mml:mn><mml:mi mathvariant=normal>c</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math>was 1.20% (0.80%–1.70%) and was higher in “6.5%” than in “7.5%” (1.70% (1.30%–2.07%) versus 0.90% (0.70%–1.30%), resp.;<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M11><mml:mi>p</mml:mi><mml:mo><</mml:mo><mml:mn fontstyle=italic>0.001</mml:mn></mml:math>). Conclusions . Our study indicates that the 7.5% threshold results in<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M12><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant=normal>H</mml:mi><mml:mi mathvariant=normal>b</mml:mi><mml:mi mathvariant=normal>A</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant=normal>1</mml:mn><mml:mi mathvariant=normal>c</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math>levels being closer to the therapeutic goal, but the actual values are still higher than those observed in the “6.5%” group. A meta-analysis of raw data from national registries or a prospective study comparing both approaches is warranted as the next step to examine this subject further." @default.
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• W2222870303 date "2016-01-01" @default.
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• W2222870303 title "The Stricter the Better? The Relationship between Targeted HbA_1cValues and Metabolic Control of Pediatric Type 1 Diabetes Mellitus" @default.
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