Pinhas-Hamiel O, Hamiel U, Boyko V, Graph-Barel C, Reichman B, Lerner-Geva L. Trajectories of HbA1c levels in children and youth with type 1 diabetes. PLoS One. 2014 Oct 2;9(10):e109109. eCollection 2014. PMID: 25275650.

PLoS One. 2014 Oct 2;9(10):e109109. doi: 10.1371/journal.pone.0109109. eCollection 2014.

Trajectories of HbA1c levels in children and youth with type 1 diabetes.

Pinhas-Hamiel O(1), Hamiel U(2), Boyko V(3), Graph-Barel C(4), Reichman B(5), Lerner-Geva L(5).

Author information:
(1)Maccabi Juvenile Diabetes Center, Raanana, Israel; Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
(2)Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
(3)The Women and Children's Health Research Unit, Gertner Institute, Tel Hashomer, Israel.
(4)Maccabi Juvenile Diabetes Center, Raanana, Israel.
(5)Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel; The Women and Children's Health Research Unit, Gertner Institute, Tel Hashomer, Israel.

PURPOSE: To illustrate the distribution of Hemoglobin A1c (HbA1c) levels according to age and gender among children, adolescents and youth with type 1 diabetes (T1DM).

METHODS: Consecutive HbA1c measurements of 349 patients, aged 2 to 30 years with T1DM were obtained from 1995 through 2010. Measurement from patients diagnosed with celiac disease (n = 20), eating disorders (n = 41) and hemoglobinopathy (n = 1) were excluded. The study sample comprised 4815 measurements of HbA1c from 287 patients. Regression percentiles of HbA1c were calculated as a function of age and gender by the quantile regression method using the SAS procedure QUANTREG.

RESULTS: Crude percentiles of HbA1c as a function of age and gender, and the modeled curves produced using quantile regression showed good concordance. The curves show a decline in HbA1c levels from age 2 to 4 years at each percentile. Thereafter, there is a gradual increase during the prepubertal years with a peak at ages 12 to 14 years. HbA1c levels subsequently decline to the lowest values in the third decade. Curves of females and males followed closely, with females having HbA1c levels about 0.1% (1.1 mmol/mol) higher in the 25th 50th and 75th percentiles.

CONCLUSION: We constructed age-specific distribution curves for HbA1c levels for patients with T1DM. These percentiles may be used to demonstrate the individual patient's measurements longitudinally compared with age-matched patients.

PMCID: PMC4183551

PMID: 25275650 [PubMed - indexed for MEDLINE]

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