AIM: to evaluate the variability of glycemic control in type 1 diabetes (DM1) patients under routine clinical care. PATIENTS AND METHODS: 100 patients (55 female), mean age of 18.6±9 years, age at diagnosis 12 (1-35) years and DM duration of 5 years (0.09-40), with a follow-up period of 4.3 (2-8.5) years. Glycated hemoglobin (HbA1c) was determined by HPLC (reference values: 2.4-6.2%). RESULTS: Data from 94 patients were analyzed. Baseline and final HbA1c were 7.6±1.8% and 8.7±2.1%, with an absolute increase of 1.1% (-7; 7.2) and an annual increase of 0.22% (-3.5; 3.6). On follow-up 6 (3-10) HbA1c were measured per patient. A significant difference in the number of HbA1c determinations was seen in the group whose glycemic control worsened (7.2±2.1) as compared to that whose glycemic control remained regular or bad (4.7±1) (p=0.003). HbA1c levels remained unchanged in 2 (2.1%), increased in 64 (68.1%) and decreased in 28 (29.8%) patients. 48 of the 94 patients (51.1%) worsened, 12 (12.8%) improved, 21 (22.3%) maintained good or excellent control and 13 (13.8%) remained with regular or bad control. The intra-individual difference between the highest and the lowest HbA1c during the study was 3.1% (0.3-9.5). The coefficient of variability and the SD of the HbA1c was 15.5±8.1% and 1.2±0.7%, respectively, and was lower in patients who remained with good or excellent control. The correlation between the final and initial HbA1c was r= 0.37 (p=0.000) and between the mean and initial HbA1c was r= 0.71 (p=0.000). CONCLUSION: The majority of our patients worsened the glycemic control during the follow-up. There was also a great intra-individual variability of the glycemic control. Baseline HbA1c has shown to be an important predictor of the glycemic control.
Type 1 diabetes mellitus; HbA1c; Glycated hemoglobin; Body mass index
