Résumé
Most people with T1D do not achieve HbA1c targets, but this may vary with patient- and disease-related factors.
SAGE was a multinational, cross-sectional study using data from medical records and interviews of eligible people with T1D for ≥1 year, aged ≥26 years (N=3858). The relationship between each group of selected factors (sociodemographics, diabetes complications and comorbidities, T1D treatment, structure and process of medical care) and HbA1c target achievement (both general [HbA1c <7 %] and individualized) were evaluated.
Overall, 24.3% of people achieved HbA1c <7 %; 20.9% achieved individualized targets. For both targets, better achievement was associated with: lower body mass index, diastolic blood pressure, and total daily insulin dose; ≥1 symptomatic hypoglycemic event (<54 mg/dL) within the last 3 months; higher levels of education; and having health insurance (Table). Poorer target achievement was associated with ≥1 severe hyperglycemic event leading to diabetic ketoacidosis within the last 6 months, microvascular complications, and dyslipidemia. Older people were more likely to achieve individualized targets while younger people were more likely to achieve HbA1c <7 %.
HbA1c target achievement remains a challenge but SAGE identified factors that appear to be associated with HbA1c target achievement, offering opportunities for intervention.