Thursday 14 January 2016

Average HBA1C By Age - Children with Type 1 Diabetes

As part of my recent study to understand what affects HBA1C results in Children with Type 1 Diabetes, today I wanted to look at the average HBA1C by age. The aim is to find out which are the easiest years to get the best control and which are the hardest. I will also be looking to see if insulin regime also plays a part, for example do teens do better with an Insulin Pump or MDI.

In 2015 over 300 parents of Children with Type 1 Diabetes  participated in a survey that I carried out online. All participants were members of various support groups on Facebook. It became apparent that this group of children already had better HBA1C results than the national average, probably because these parents are amongst the most committed to improving blood glucose control for their children.


AVERAGE HBA1C BY AGE GROUP


The overall average HBA1C of the group was 7.8%.  Here we take a look at the average HBA1C by age group. It makes very interesting reading.


Aged 0 - 3 = Average HBA1C 7.64%

Aged 4 - 10 = Average HBA1C 7.30%

Aged 11 - 15 = Average HBA1C 7.70%

Aged 16 - 19 = Average HBA1C  8.02%

I don't think these results are particularly surprising, it's common knowledge that the teen years present so many challenges, with hormones and teenage rebellion playing a big part. Now we are going to look at the same age groups again and see how these results vary depending on which insulin regime the children are using, to identify how insulin pumps and injections in these age groups can affect HBA1C.

AVERAGE HBA1C BY AGE GROUP - INSULIN PUMPS AND INJECTIONS


In a previous article I have already studied the impact of insulin pumps against multiple daily injections to discover the effect on HBA1C, you can read those results here. However I'm now going to break the data down even further and look at the effect between the 2 insulin regimes by age group.

Age Group 0 - 3

Insulin Pump Users Aged 0 - 3 = Average HBA1C 7.69%
Children on Injections Aged 0 - 3 = Average HBA1C 7.43%

I think it's important to state here that there was limited data available for this age group of children on MDI, it was a very small group indeed as most children that are diagnosed with Type 1 Diabetes at a very young age are put straight onto insulin pumps, so I'm not convinced that the differences in HBA1C within this age group are a correct representation.

Age Group 4 - 10

Insulin Pump Users Aged 4 - 10 = Average HBA1C 7.18%
Children on Injections Aged 4 - 10 = Average HBA1C 7.53%

This was the largest age group with a very similar numbers of children using insulin pumps as there were injections. This data would suggest that primary aged children can gain significant benefits from using an insulin pump to improve their HBA1C. Though it's fair to mention that there were excellent results acheived by both groups of parents/children.

Age Group 11 - 15

Insulin Pump Users Aged 11 - 15 = Average HBA1C 7.45%
Children on Injections Aged 11 - 15 = Average HBA1C 8.08%

It was good to see in this group of children a larger percentage of children were using insulin pumps compared to injections especially as it would seem that this has given them an improved average HBA1C of over 0.5% which is highly important as things do become harder in this age group, as there is less parental control within the high school environment and those hormones really step up a gear. I would be interested to know if this is due to being able to set specific basal patterns overnight to overcome the impact of hormones or if it's due to the improvement to quality of life for these children.

Age Group 16 - 19

Insulin Pump Users Aged 16 - 19 = Average HBA1C 7.71%
Children on Injections Aged 16 - 19 = Average HBA1C 8.45%

We had already discovered that this age group seem to have the highest average HBA1C though this data would suggest that it is this age group that can most benefit from having an insulin pump.

Now before we all go away and worry about those teenage years, panicking about how we are going to deal with them and achieve good blood glucose control,  I want to tell you that in both groups of children, there were results below 7% for both insulin pump users and those on injections....it can be done and I would really appreciate it if those parents could share there tips below in the comments section and let us know how they and their children have managed that.

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