Abstract
Background Treatment of patients with type 1 diabetes requires experience and a specific infrastructure. Therefore, center size might influence outcome in diabetes treatment. Objective To analyze the influence of center size on the quality of diabetes treatment in children and adolescents in Germany and Austria. Patients and methods In 2009 and 2018, we analyzed metabolic control, acute complications, and rates of recommended screening tests in the DPV cohort. Diabetes centers were classified according to the number of patients from XS to XL (<20 [XS], >= 20 to <50 [S], >= 50 to <100 [M], >= 100 to <200 [L], >= 200 [XL]). Results Over the 10-year period, metabolic control improved significantly in M, L and XL diabetes centers. Treatment targets are best achieved in M centers, while XS centers have the highest mean hemoglobin A1c. The relation between hemoglobin A1c and center size follows a v-shaped curve. In 2009, conventional insulin therapy was most frequently used in XS centers, but in 2018, there was no difference in mode of insulin therapy according to center size. Use of CSII and sensor augmented CSII/hybrid closed loop increased with center size. Patients cared for in XS diabetes centers had the fewest follow-up visits per year. The rates of severe hypoglycemia and DKA were lowest in XL diabetes centers, and the rate of DKA was highest in XS centers. Conclusion Center size influences quality of care in pediatric patients with type 1 diabetes. Further investigations regarding contributing factors such as staffing and financial resources are required.
| Dokumententyp: | Zeitschriftenartikel |
|---|---|
| Fakultät: | Medizin |
| Themengebiete: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit |
| ISSN: | 1399-543X |
| Sprache: | Englisch |
| Dokumenten ID: | 98671 |
| Datum der Veröffentlichung auf Open Access LMU: | 05. Jun. 2023, 15:29 |
| Letzte Änderungen: | 17. Okt. 2023, 14:59 |
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