By Mie Tomzak

DDA-funded researcher Pernille Falberg Rønn is one of the authors of a publication based on a nationwide Danish cohort study of the trajectory and predictors of glycated haemoglobin in children and adolescents.

Poor glycemic control in type 1 diabetes increases the risk of chronic complications, and it is essential to identify associated life periods and predictors. A study recently published in Pediatric Diabetes delves into this, and DDA-funded researcher Pernille Falberg Rønn is listed as one of the authors.

Pernille Falberg Rønn has a degree in public health, and she is currently in a three-year postdoc project at the department for Clinical Epidemiological Research at Steno Diabetes Center Copenhagen.

Pernille is interested in the epidemiology of diabetes, and in the current project, her focus is on developmental patterns of glycemic control through a lifetime with type 1 diabetes, the risk factors of an adverse disease course, and the development of diabetic complications. All this is studied by linking data from national registers and clinical databases.

What predicts an adverse HbA1c trajectory?
The publication ‘Trajectory and predictors of HbA1c in children and adolescents with type 1 diabetes – A Danish nationwide cohort study’ from Pediatric Diabetes lists Pernille Falberg Rønn as the last author. The article is co-written by Else Helene Ibfelt, Rasmus Wibæk, Dorte Vistisen, Gregers S. Andersen, Marit E. Jørgensen, Adam Hulman, Dana Dabelea, Niels H. Birkebæk, and Jannet Svensson.

“We wished to study how levels of glycated haemoglobin (HbA1c) develops through childhood and adolescence in people with type 1 diabetes, because we know that especially the teenage years can be challenging, which is often reflected in higher levels of HbA1c. It has not yet been studied how the development of HbA1c looks, and which clinical and sociodemographic factors are important for detrimental patterns of HbA1c levels, at least not in such a big national cohort of Danish children with repeated measurements,” explains Pernille Falberg Rønn.

“We analysed measurements of HbA1c and information gathered at annual physical exams of all children and young people (2-18 years) with type 1 diabetes in Denmark from 1996-2019. Overall, we analysed data from 5889 individuals,” says Pernille Falberg Rønn.

“In this study, we generally see increasing levels of HbA1c through childhood and adolescence, and that the most important predictors for poor HbA1c trajectories were shorter education of the parents, non-Danish origin, and, in particular, low frequency of blood glucose monitoring (BGM). Surprisingly enough, we do not see a difference in the development of HbA1c among users of insulin pens compared to users of insulin pumps. However, other studies suggest that pump technology may be related to a higher health related quality of life compared to pen use. In addition, a good piece of news is that the average population level of HbA1c has fallen in the period of 1996-2019,” says Pernille Falberg Rønn.

Attention towards vulnerable groups needed
As Pernille explains it, the results can be used in clinical practice and future research to direct attention towards the teenage years and vulnerable groups, such as children with another ethnic background and/or parents with shorter education. Furthermore, the results point to the importance of behavioural aspects of diabetes treatment, such as blood glucose self-monitoring.

For her own future, Pernille Falberg Rønn has more than a few things to look forward to, both in regards to her private life and her research.

“I am going on maternity leave, and afterwards I will do a research stay with one of our collaborators at Colorado School of Public Health. For the research part, we are going to investigate how the development of HbA1c and other factors are associated with diabetes complications in youth and adulthood by developing and testing advanced statistical models that can predict the risk of developing complications. We will continue to use the Danish registers to get a life course perspective on living with type 1 diabetes to increase the knowledge on particular vulnerable groups and time periods for intervention,” says Pernille Falberg Rønn.

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READ THE ARTICLE HERE:
‘Trajectory and predictors of HbA1c in children and adolescents with type 1 diabetes—A Danish nationwide cohort study’
Else Helene Ibfelt, Rasmus Wibaek, Dorte Vistisen, Gregers S. Andersen, Marit E. Jørgensen, Adam Hulman, Dana Dabelea, Niels H. Birkebaek, Jannset, Svensson, Pernille F. Rønn
Pediatric Diabetes, 2022;1-8, DOI:10.1111/pedi.13337
Published 02 April 2022 

CONTACT DETAILS:
Pernille Falberg Rønn
Postdoc, Steno Diabetes Center Copenhagen
Email: pernille.falberg.roenn@regionh.dk