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Objective: We investigated the incidence of pediatric type 2 diabetes (T2D) in Germany during two years of the COVID-19 pandemic (2020-2021), compared with the control period 2011-2019. Study design and methods: Data on T2D in children (6 to Results: The incidence of youth-onset T2D increased from 0.75 per 100,000 patient-years [PY] in 2011 (95% CI 0.58; 0.93) to 1.25 per 100,000 PY in 2019 (95% CI 1.02; 1.48), an annual increase of 6.8% (95% CI 4.1; 9.6). In 2020, T2D incidence increased to 1.49 per 100,000 PY (95% CI 1.23; 1.81), which was not significantly higher than predicted (IRR 1.15, 95% CI 0.90; 1.48). In 2021, the observed incidence was significantly higher than expected (1.95 [95% CI 1.65; 2.31] vs. 1.38 [1.13; 1.69] per 100,000 PY; IRR 1.41 [1.12; 1.77]). While there was no significant increase in incidence in girls in 2021, the observed incidence in boys (2.16 [1.73; 2.70] per 100,000 PY) significantly exceeded the predicted rate (IRR 1.55 [1.14; 2.12]), leading to a reversal of the sex ratio of pediatric T2D incidence. Conclusions: In Germany, incidence of pediatric type 2 diabetes increased significantly in 2021. Adolescent males were more affected by this increase, resulting in a reversal of the sex ratio of youth-onset T2D.

Objective To investigate whether socioeconomic deprivation and urbanization are associated with the frequency of diabetic ketoacidosis (DKA) at diagnosis of pediatric type 1 diabetes. Research Design and Methods Children and adolescents aged ≤18 years, living in Germany, with newly diagnosed type 1 diabetes documented between 2016 and 2019 in the prospective diabetes follow-up registry (DPV) were assigned to a quintile of regional socioeconomic deprivation (German Index of Socioeconomic Deprivation) and to a degree of urbanization (Eurostat), using their residence postal code. With multiple logistic regression models, we investigated whether the frequency of DKA at diagnosis was associated with socioeconomic deprivation or urbanization, and if associations differed by age group, sex or migration status. Results In 10,598 children and adolescents with newly diagnosed type 1 diabetes, the frequency of DKA was lowest in the least deprived regions (Q1: 20.6% [95%-CI: 19.0-22.4%], and increased with growing socioeconomic deprivation to 26.9% [25.0-28.8%] in the most deprived regions (Q5) (P for trend Conclusions This study provides evidence that prevention of DKA at diagnosis by means of awareness campaigns and screening for pre-symptomatic type 1 diabetes should particularly target socioeconomically disadvantaged regions and rural areas.

Objective To estimate the prevalence of diabetes due to diseases of the exocrine pancreas (DEP) using data of the multicentre diabetes patient follow-up registry. Moreover, we aimed at comparing individuals with diabetes due to DEP to individuals with type 1 and type 2 diabetes. Methods Individuals with DEP, type 1 or type 2 diabetes ≥18 years of age were studied. We aggregated the most recent treatment year per patient and used propensity scores to match diabetes due to DEP to type 1 and type 2 diabetes. Matching was conducted one-to-one with sex, age, diabetes duration, migration background and the German index of socioeconomic deprivation as covariates. Results We identified 7,093 (1.6%) individuals with diabetes due to DEP. In the matched cohort DEP-type 1 diabetes we observed a similar daily insulin dose (0.62 IU/kg (95% confidence interval:0.60–0.63), 0.60 IU/kg (0.58–0.62)) and significant differences regarding microvascular (41.0% (39.7–42.2), 45.3% (44.0–46.6)), and macrovascular disease (16.6% (15.7–17.6), 14.7% (13.8–15.6)). HbA1c (8.2% (8.1–8.3), 7.9% (7.8–8.0)), daily insulin dose (0.60 IU/kg (0.58–0.62), 0.56 IU/kg (0.54–0.58)) and event rates of severe hypoglycemia (23.9 events/100 PY (21.4–26.8), (9.5 events/100 PY (8.0–11.2)) were significantly higher in individuals with diabetes due to DEP compared to type 2 diabetes. Conclusions Using registry data, rare diabetes types such as diabetes due to DEP can be studied with a significant sample size. Our study identified differences and similarities between adult individuals with DEP related diabetes and type 1 or type 2 diabetes.

Highlights This prospective study compares 15 patients with immune‐checkpoint induced diabetes mellitus (CPI‐DM) with a propensity score matched cohort of patients with other diabetes types. Diabetic ketoacidosis at onset and autoimmune comorbidity is more frequent in CPI‐DM patients. This can be avoided by regular glucose measurements and education on hyperglycemia. Background To describe checkpoint inhibitor‐induced diabetes mellitus (CPI‐DM) and to compare with regular type 1 (T1DM), type 2 (T2DM), and medication‐induced diabetes mellitus (MI‐DM). Methods We included 88 177 adult patients from the Diabetes Patient Follow‐Up (DPV) registry with diabetes manifestation between 2011 and 2020. Inclusion criteria were T1DM, T2DM, MI‐DM, or CPI‐DM. Because of the heterogeneity between the groups, we matched patients by age, sex, and diabetes duration using propensity scores. Patient data were aggregated in the respective first documented treatment year. Results The matched cohort consisted of 24 164 patients; T1DM: 29, T2DM: 24000, MI‐DM: 120, CPI‐DM: 15 patients. Median age at manifestation of CPI‐DM patients was 63.6 (57.2‐72.8) years (53.3% male). Body mass index in CPI‐DM patients was significantly lower (26.8 [23.9‐28.1] kg/m2) compared with T2DM patients (29.8 [26.2‐34.3] kg/m2, P = 0.02). At manifestation, HbA1c was significantly higher in CPI‐DM compared with MI‐DM, but there was no difference during follow‐up. Diabetic ketoacidosis (DKA) was documented in six CPI‐DM patients (T1DM: 0%, T2DM: 0.4%, MI‐DM: 0.0%). Fourteen CPI‐DM patients were treated with insulin, and three received additional oral antidiabetics. The most common therapy in T2DM was lifestyle modification (38.8%), insulin in MI‐DM (52.5%). Concomitant autoimmune thyroid disease was present in four CPI‐DM patients (T1DM: 0.0%, T2DM: 1.0%, MI‐DM: 0.8%). Conclusions The data from this controlled study show that CPI‐DM is characterized by a high prevalence of DKA, autoimmune comorbidity, and metabolic decompensation at onset. Structured diagnostic monitoring is warranted to prevent DKA and other acute endocrine complications in CPI‐treated patients., publishedVersion

Use of continuous glucose monitoring (CGM) systems has become standard of care in type 1 diabetes (T1D) in many countries, particularly in children and adolescents (1,2). Results from clinical trials indicate that use of CGM leads to improved metabolic control and reduction in nonsevere hypoglycemia compared with self-monitoring of capillary blood glucose (3,4). Benefits are seen irrespective of insulin delivery method (pump or pen) (4,5) but are conditioned on near-daily sensor usage (4). Trial participants, however, are often biased toward higher education level, greater therapy adherence, and better self-management. Small sample size and short trial duration very often preclude appropriate assessment of CGM impact on rare events such as severe hypoglycemia (SH) or diabetic ketoacidosis (DKA). We therefore used real-world data from the German-Austrian-Swiss-Luxembourgian Diabetes Prospective Follow-up (DPV) registry to longitudinally assess HbA1c, SH, and DKA during the first year after initiation of CGM, including real-time CGM and intermittently scanned/viewed CGM. Anonymized patient registry records were analyzed. SH was defined as events requiring external assistance by another person and events resulting in coma/convulsion. DKA was defined by pH level

Objectives Only a fraction of youth meet established targets for glycemic control; many experience deteriorating control over time. We compared trajectories of hemoglobin A1c (HbA1c) among youth from three trans-continental type 1 diabetes (T1D) registries and identified clinical variables associated with the odds of following increasing vs stable trajectories. Research design and methods Analyses included longitudinal data from 15 897 individuals age 8 to 18 with T1D for at least 2 years and HbA1c measurements in at least 5 years during the observation period. Cohorts were selected from Australasian Diabetes Data Network (ADDN; Australia), German/Austrian/Luxembourgian Diabetes-Patienten-Verlaufsdokumentation initiative (DPV; Germany/Austria/Luxembourga), and the T1D Exchange Clinic Network (T1DX; US) clinic registries. Group-based trajectory modeling and multivariable logistic regression identified unique HbA1c trajectories and their predictors. Results Five heterogeneous trajectories of glycemic control in each registry were identified: low, intermediate, high stable; intermediate and high increasing. The overall HbA1c level for each trajectory group tended to be lowest in the DPV, higher in the ADDN, and highest in the T1DX. The absolute level of HbA1c and the proportion of individuals within each trajectory varied across registries: 17% to 22% of individuals followed an increasing trajectory. Compared with maintaining a stable trajectory, following an increasing trajectory was significantly associated with ethnic minority status, lower height z-score, higher BMI z-score, insulin injection therapy, and the occurrence of severe hypoglycemia; however, these factors were not consistent across the three registries. Conclusions We report the first multinational registry-based comparison of glycemic control trajectories among youth with T1D from three continents and identify possible targets for intervention in those at risk of an increasing HbA1c trajectory.

Evidence for the metabolic impact of long-term exposure to air pollution on diabetes is lacking. We investigated the association of particulate matter10 μm (PMWe studied data of 44,383 individuals with T1D 21 years which were documented in 377 German centres within the diabetes prospective follow-up registry (DPV) between 2009 and 2018. Outcomes were aggregated by year and by patient. PMAdjusted mean HbA1c increased with PMAir pollution was associated with higher HbA1c levels and increased risk of severe hypoglycaemia in people with T1D, consequently indicating a higher risk of diabetes complications. Further studies are needed to explore causal pathways of the observed associations.

Pediatric diabetes 22(3), 455-462 (2021). doi:10.1111/pedi.13185, Published by Wiley-Blackwell, Oxford [u.a.]

Objective To analyze the interrelationship of metabolic control, age- and sex-adjusted body mass index, and daily insulin dose and to identify heterogeneous multivariate developmental curves from childhood to young adulthood in a large cohort of children with type 1 diabetes (T1D) Study design Data were extracted from the diabetes follow-up registry DPV. Longitudinal data from 9239 participants with T1D age 8-18 years with diabetes duration ≥2 years and ≥5 years of follow-up were analyzed. We applied group-based multitrajectory modeling to identify latent groups of subjects following similar developmental curves across outcomes (hemoglobin A1c [HbA1c], age/sex-standardized body mass index [BMI-SDS], daily insulin dose per kg). Group number was based on Bayes information criterion and group size (≥5%). Results The group-based multitrajectory approach revealed 5 heterogeneous 3-variate trajectories during puberty. Individuals with stable good metabolic control, high-normal increasing BMI-SDS, and rising insulin dose patterns were classified as group 1 (33%). Group 2 (20%) comprised youths with intermediate-increasing HbA1c, low BMI-SDS, and steeply increasing insulin dose trajectories. Group 3 (11%) followed intermediate-rising HbA1c and high-normal increasing BMI-SDS developmental curves, while insulin dose increased steeply. In group 4 (14%), both high-increasing HbA1c and insulin dose trajectories were observed, while BMI-SDS was stable-normal. Group 5 (22%) included subjects with intermediate-rising HbA1c patterns, high-increasing BMI-SDS, and increasing insulin dose patterns. Conclusions This study identified 5 distinct 3-variate curves of HbA1c, BMI-SDS, and insulin dose during puberty among youths with T1D. This approach demonstrates a considerable heterogeneity highlighting the importance of personalized medical care.

The glucose management indicator (GMI) estimates HbA1c from continuous glucose monitoring (CGM) profiles. The formula was developed with real-time CGM (rtCGM) sensors (1). As previous data indicated discrepancies between observed laboratory HbA1c and CGM-derived estimates of HbA1c for some individuals and sensor types (1,2), we aimed to compare observed HbA1c and GMI using both rtCGM and intermittent scanning CGM (iscCGM) profiles collected during routine care in people with type 1 diabetes. We analyzed 132,361 CGM days from a total of 1,973 individuals with type 1 diabetes for ≥1 year from the German/Austrian/Swiss/Luxembourgian Prospective Diabetes Follow-up Registry (DPV) (3). As measurement ranges of the CGM devices differed, we truncated glucose values to the same range (40–400 mg/dL). We calculated the GMI from up to 90 CGM days per individual (median \[interquartile range] 77 [46–89] days per individual) as GMI (%) = 3.31 + 0.02392 ⋅ [mean glucose (mg/dL)\] (1). We compared GMI and observed HbA1c at the end of the 90-day period overall and by age-group. Absolute differences between GMI and observed HbA1c were illustrated for rtCGM vs. iscCGM and stratified by glucose variability, normal weight vs. overweight, and HbA1c 90th percentile for individuals aged 25 kg/m2 …

OBJECTIVE Worsening of glycemic control in type 1 diabetes during puberty is a common observation. However, HbA1c remains stable or even improves for some youths. The aim is to identify distinct patterns of glycemic control in type 1 diabetes from childhood to young adulthood. RESEARCH DESIGN AND METHODS A total of 6,433 patients with type 1 diabetes were selected from the prospective, multicenter diabetes patient registry Diabetes-Patienten-Verlaufsdokumentation (DPV) (follow-up from age 8 to 19 years, baseline diabetes duration ≥2 years, HbA1c aggregated per year of life). We used latent class growth modeling as the trajectory approach to determine distinct subgroups following a similar trajectory for HbA1c over time. RESULTS Five distinct longitudinal trajectories of HbA1c were determined, comprising group 1 = 40%, group 2 = 27%, group 3 = 15%, group 4 = 13%, and group 5 = 5% of patients. Groups 1–3 indicated stable glycemic control at different HbA1c levels. At baseline, similar HbA1c was observed in group 1 and group 4, but HbA1c deteriorated in group 4 from age 8 to 19 years. Similar patterns were present in group 3 and group 5. We observed differences in self-monitoring of blood glucose, insulin therapy, daily insulin dose, physical activity, BMI SD score, body-height SD score, and migration background across all HbA1c trajectories (all P ≤ 0.001). No sex differences were present. Comparing groups with similar initial HbA1c but different patterns, groups with higher HbA1c increase were characterized by lower frequency of self-monitoring of blood glucose and physical activity and reduced height (all P < 0.01). CONCLUSIONS Using a trajectory approach, we determined five distinct longitudinal patterns of glycemic control from childhood to early adulthood. Diabetes self-care, treatment differences, and demographics were related to different HbA1c courses.

Worsening metabolic control, weight changes and increasing insulin dose during puberty have emerged as a challenge in diabetes care. However, individual variation is large. Data from the German/Austrian/Luxembourgian diabetes registry DPV were used to identify distinct patterns of hemoglobin A1c (HbA1c), age/sex-standardized body mass index (BMI-SDS) and daily insulin dose from childhood to young adulthood. Longitudinal data from 9,239 participants with T1D aged 8 to 18 years with duration >=2 years and >=5 years of follow-up were analyzed. We applied group-based multitrajectory (GBMT) modeling, a generalization of the group-based trajectory approach, to identify latent groups of subjects following similar developmental curves over time across multiple variables (Nagin, 2018). The GBMT approach revealed five unique groups of heterogeneous HbA1c, BMI-SDS and insulin dose patterns over time (Fig1). Differences in age at onset, gender, migration background as well as height-SDS, insulin pump and CGM usage, frequency of SMBG and physical activity were found across all groups. The present study identified for the first time five distinct multitrajectories of HbA1c, BMI-SDS and insulin dose during puberty. This approach demonstrates that variability between individuals is obscured by statistics on central tendency. Disclosure A. Schwandt: None. O. Kuss: None. D.P. Dunstheimer: None. B. Karges: None. T.M. Kapellen: None. T. Meissner: None. M. Witsch: None. M. Flury: Other Relationship; Self; Pfizer Inc. S. Straubinger: None. R.W. Holl: None. Funding German Center for Diabetes Research; Robert Koch Institute; German Diabetes Association

Aim Comparing people with Type 2 diabetes mellitus with and without heart failure in terms of metabolic control, therapeutic regimen and comorbidities. Methods The Prospective Diabetes Registry (DPV) is a longitudinal documentation system for demographics, medical care and outcome in people with diabetes mellitus. It consists of follow‐up data from people with diabetes mellitus who have agreed to be recorded in the registry. Clinical data are submitted by general practitioners, specialists and clinics throughout Germany and Austria. Some 289 954 people with Type 2 diabetes mellitus (years 2000 to 2015) were analysed using demographic statistics and adjustment for confounders based on linear and logistic regression analysis. Results People with Type 2 diabetes mellitus (ICD code: E11) and heart failure (ICD code: I50) (N = 14 723) were older, more often women and presented with longer diabetes duration compared with those without heart failure. After adjustment for age, gender and diabetes duration, people with heart failure showed lower HbA1c, higher BMI and more intense insulin therapy. Analysis revealed that people with heart failure were more often treated with insulin, and more frequently received anti‐hypertensives and lipid‐lowering medication. They presented with lower systolic and diastolic BP. People with heart failure more frequently showed a history of comorbidities. Conclusion Heart failure is common in diabetes mellitus, but the prevalence in the DPV is lower frequent than expected. The reason for improved metabolic control in heart failure may be intensified therapy with insulin, lipid‐lowering medication and anti‐hypertensives in this cohort., What's new? Heart failure is a common comorbidity of diabetes mellitus. Prevalence data from intervention studies do not represent real‐world data because the people in studies are often pre‐specified with relation to several underlying diseases. For Germany, data on heart failure prevalence among people with Type 2 diabetes mellitus from large representative cohorts are currently unavailable. Data on diabetes treatment and therapeutic regimens regarding other comorbidities in people with Type 2 diabetes and heart failure are rare.The Prospective Diabetes Registry (DPV) delivers data from nearly 290 000 people with Type 2 diabetes in specialized diabetes care and thus represents real‐world data.The DPV provides data on clinical situation, diabetes treatment and therapeutic regimens regarding other comorbidities in people with Type 2 diabetes and heart failure from all over Germany.The DPV is commonly used to document the real‐world treatment of people with diabetes and either heart failure or other comorbidities. The DPV clearly shows insufficient treatment of dyslipidaemia in people with diabetes and heart failure.

This article gives a short summary of standardized documentation for pediatric diabetology from a European perspective. The approach chosen by the Austrian/German DPV (Diabetes Patienten Verlaufsdokumentation) group is detailed. The electronic health record used is briefly described, as are external benchmarking reports and national and international comparisons. Similar initiatives like the Hvidore study group, the SWEET initiative (Pediatric Diabetes: Working to Create Centers of Reference in Europe), and the T1DExchange (Type 1 Diabetes Exchange Registry) are compared to the DPV effort.

BACKGROUND A paucity of reports in the literature exists concerning the co-existence between autism spectrum disorder (ASD) and type 1 diabetes (T1D). OBJECTIVE To compare clinical characteristics, diabetes management and metabolic control in youth with T1D and ASD (T1D-ASD) with youth without ASD (T1D-non ASD). METHODS Using the German/Austrian diabetes patient follow-up registry, this study analyzed aggregated data from the last available year of observation for each patient with T1D, ages 1-20 with consistent data on insulin regimen and glycated hemoglobin (A1C), between January, 2005 and March, 2017. RESULTS From 61 749 patients, 150 (0.24%) were identified as T1D-ASD. Non-adjusted comparisons showed similar results for mean age at onset and duration of diabetes, but not for gender (male: T1D-ASD: 85.3%; T1D-non ASD: 52.8%; P

OBJECTIVE To investigate whether celiac disease (CD) associated with type 1 diabetes increases the risk of microvascular complications. RESEARCH DESIGN AND METHODS Patients (n = 56,514) aged >10 years with diabetes duration RESULTS Kaplan-Meier analysis revealed that retinopathy and nephropathy occurred earlier in the presence versus absence of CD: retinopathy at age 26.7 years (95% CI 23.7–30.2) in 25% of patients with CD vs. age 33.7 years (33.2–34.4) in 25% without CD and microalbuminuria at age 32.8 years (29.7–42.5) vs. 42.4 years (41.4–43.3). The adjusted risk for both retinopathy (hazard ratio 1.263 [95% CI 1.078–1.481]) and nephropathy (1.359 [1.228–1.504]) was higher in patients with diabetes and CD versus those without CD. Cox regression revealed CD as an independent risk factor for microvascular complications after adjustment for confounders. CONCLUSIONS CD is an independent risk factor for retinopathy and nephropathy in patients with type 1 diabetes. Our study therefore supports the recommendation for regular serologic testing for CD, even in the absence of clinical CD. Further prospective studies are required to investigate whether a gluten-free diet might reduce the risk of microvascular disorders in patients with diabetes and CD.

Objectives In a contemporary cohort of youth with type 1 diabetes, we examined the interval between episodes of severe hypoglycemia (SH) as a risk factor for recurrent SH or hypoglycemic coma (HC). Methods This was a large longitudinal observational study. Using the DPV Diabetes Prospective follow-up data, we analyzed frequency and timing of recurrent SH (defined as requiring assistance from another person) and HC (loss of consciousness or seizures) in 14 177 youths with type 1 diabetes aged Results Among 14 177 patients with type 1 diabetes, 72% (90%) had no, 14% (6.8%) had 1 and 14% (3.2%) >1 SH (HC). SH or HC in the last year of observation was highest with SH in the previous year (odds ratio [OR] 4.7 [CI 4.0-5.5]/4.6 [CI 3.6-6.0]), but remained elevated even 4 years after an episode (OR 2.0 [CI 1.6-2.7]/2.2 [CI 1.5-3.1]). The proportion of patients who experienced SH or HC during the last year of observation was highest with SH/HC recorded during the previous year (23% for SH and 13% for HC) and lowest in those with no event (4.6% for SH and 2% for HC) in the initial 4 years of observation. Conclusions Even 4 years after an episode of SH/HC, risk for SH/HC remains higher compared to children who never experienced SH/HC. Clinicians should continue to regularly track hypoglycemia history at every visit, adjust diabetes education and therapy in order to avoid recurrences.

Background With increasing obesity in childhood and adolescence, weight gain, and insulin resistance become also more frequent in patients with type 1 diabetes mellitus (T1DM). Especially during puberty, insulin therapy often has to be intensified and higher insulin doses are necessary. Some studies point to a beneficial effect of metformin in addition to insulin in these patients. In order to describe current practice and possible benefits, we compared pediatric T1DM patients with insulin plus metformin (n = 525) to patients with insulin therapy only (n = 57 487) in a prospective multicenter analysis. Methods Auxological and treatment data from 58 012 patients aged

Background The long-acting insulin analogue degludec is a therapeutic option for patients with type 1 (T1D) or type 2 diabetes (T2D). Aim of this analysis was to investigate differences in clinical characteristics of patients before and after initiating degludec use in a cohort of German/Austrian patients. Methods 1064 subjects with T1D/T2D and documented degludec use from the Diabetes-Patient-Follow-Up (DPV) registry were included. The follow-up cohort (n = 421) comprised patients with available data before and 3–15 months after switching to degludec. A t-test for paired values was implemented to compare rates of severe hypoglycaemia, and mean values for HbA1C, BMI, basal insulin dose/kg bodyweight/day, and the number of basal insulin injections/day before and after switching to degludec Results were stratified by type of diabetes. In T1D, subgroup analyses were conducted (age, sex, basal insulin used before switching). P Findings In T1D (n = 360), basal insulin dose (0.43 ± 0.17 to 0.38 ± 0.13 IU) and the number of basal injections/day (1.7 ± 0.6 to 1.1 ± 0.3) decreased whereas BMI increased from 23.2 ± 4.8 to 24.0 ± 5.0 kg/m2 (all p Conclusions The DPV registry provides data from real-life diabetes care. Our analysis predominantly confirmed results from clinical trials and provides additional information complementing the clinical study program of degludec.

To characterize the clinical and immunological features of HLA-typed youth with pediatric onset of type 2 diabetes mellitus (T2DM).One hundred and seven patients with clinically diagnosed T2DM (aged

OBJECTIVE In clinical practice Body Mass Index is generally used to evaluate overweight status in adults. The present multicenter study examines whether Body Mass Index (BMI), age- and gender-adjusted Body Mass Index Standard Deviation Score, or calculated %body fat is a better predictor for cardiovascular disease risk factors, specifically hypertension and dyslipidemia, in a high-risk population. METHODS Data of 42 048 adult type 2 diabetic patients (median age: 67.1 years) from 161 centers in Germany (n=158) and Austria (n=3) registered in a standardized, prospective, computer-based documentation program, were included in the study. For each patient body weight, height, blood pressure and blood lipids were documented. Spearman correlation analyses as well as multivariable logistic regression models were used to examine the relationship between anthropometric measurements and cardiovascular disease risk factors. RESULTS Correlation and regression analyses revealed minor, non significant differences between the 3 anthropometric measurements (all p>0.05). In both genders, relationships between anthropometric measurements and hypertension or reduced HDL-cholesterol were nearly identical. Only for increased triglycerides, the relations with the 3 anthropometric measurements were significantly stronger in males than in females (p

Background The risk of hypoglycemia increases after alcohol consumption in patients with type 1 diabetes. This study aimed to investigate the association between metabolic control and self-reported alcohol consumption in young patients with type 1 diabetes. Materials and Methods N = 29 630 patients with type 1 diabetes aged 12 to

PLoS one 11(8), e0160971 (2016). doi:10.1371/journal.pone.0160971, Published by PLoS, Lawrence, Kan.

Cardiovascular diabetology 15, 72 (2016). doi:10.1186/s12933-016-0391-8, Published by BioMed Central, London

Diabet. Med. 29, 1327–1334 (2012) Abstract Aims To estimate direct costs of paediatric Type 1 diabetes care and associated factors in Germany for the year 2007 and to compare results with the costs for the year 2000. Methods Our study includes clinical data and charges for any diabetes-related health care service of 14 185 continually treated subjects with paediatric diabetes aged

Bachran R, Beyer P, Klinkert C, Heidtmann B, Rosenbauer J, Holl RW; for the German/Austrian DPV Initiative, the German Pediatric CSII Working Group and the BMBF Competence Network Diabetes. Basal rates and circadian profiles in continuous subcutaneous insulin infusion (CSII) differ for preschool children, prepubertal children, adolescents and young adults. Objective: Initiation of continuous subcutaneous insulin therapy (CSII) requires an appropriate basal rate profile. Different approaches exist; however, there is a lack of evidence-based recommendations, especially in young children. Study design: In this large multicenter survey, 5941 CSII patients from the German/Austrian prospective documentation system (DPV) were analyzed. Patients were divided into four age groups

Aims To conduct a multicentre, matched-pair cohort analysis comparing glycaemic control and adverse events of continuous subcutaneous insulin infusion (CSII) with multiple daily injections (MDI) in paediatric patients. Methods Using standardized computer-based prospective documentation, HbA1c, insulin dose, body mass index–standard deviation score (BMI–SDS), rate of hypoglycaemia, rate of diabetic ketoacidosis (DKA) and intensity of care were analysed in 434 matched pairs during a follow-up period of 3 years after initiation of MDI or CSII. Results HbA1c was significantly lower in the CSII group during the first year of new regimen (CSII 7.5 ± 0.05 vs. MDI 7.7 ± 0.06; P

Effects of diabetes treatment are strongly connected to individual factors, but the relevant role of gender has not been addressed so far. This observational study evaluates whether monotherapy with lifestyle, metformin or sulfonylurea has gender-specific effects on glycemic control and/or body weight. Data of 9 108 patients with type 2 diabetes from 129 German diabetes centers were assessed by a standardized, prospective, computer-based diabetes care and outcome documentation system (DPV-Wiss-database; age 63.1±12.8 years, diabetes duration 5.7±7.4 years, HbA1c 55±17.7 mmol/mol [7.2±1.6%], BMI 30.6±6.1 kg/m(2), 49.3% female patients). Antidiabetic concepts included lifestyle intervention (n=5,787), metformin (n=2,180), sulfonylurea (n=943) or other antidiabetic drugs (n=198), respectively. HbA1c and body weight were compared before and after a stable monotherapeutical period of 0.8±0.4 years. Women had a significantly higher reduction of body weight after treatment with lifestyle (women-0.8±0.1 vs. men-0.2±0.1 kg; p