Abstract
Aim: To compare demographics, therapeutics and outcomes in children and adolescents with diabetes in Aotearoa, New Zealand from the KiwiDiab network.
Methods: All cases of type 1 diabetes (T1D) and type 2 diabetes (T2D) from the 13 regional centres that provide care were collated for the 2023 calendar year.
Results: There were 1849 children and adolescents with diabetes: 1642 (88.8%) had T1D, mean age at diagnosis 9 years (interquartile range [IQR]: 6-12), mean age in clinic 12 years (IQR: 9-14); 47% were female and 69% identified as NZ European, 16% Māori and 8.3% Pacific. Overall, 23% of children and adolescents with T1D achieved an HbA1c level < 53 mmol/mol (7.0%). The mean (±standard deviation) HbA1c for any insulin pump use was 59 ± 11 mmol/mol (7.5% ± 1.0%) compared to 72 ± 19 (8.7% ± 1.8%) for those on multi-daily injections (MDI) and 96 ± 25 (11.0% ± 2.3%) on twice-daily (BD) insulin (p < 0.001). For the 23% of those using automated insulin delivery, mean HbA1c was similar across ethnic groups. However, HbA1c was higher for those on MDI or BD of Pacific or Māori versus European or Asian ethnicity (p < 0.001). There were 151/1849 (8.2%) children and adolescents with T2D: mean age at diagnosis 13 years (IQR: 12-14), age in clinic 14 years (IQR: 12-15); 61% were female, 38% Māori and 42% Pacific.
Conclusions: This inaugural national benchmarking report demonstrates the differences in diabetes technology usage and HbA1c levels for children and adolescents in Aotearoa, New Zealand. This highlights the need for ongoing benchmarking activities on a regular basis.