![]() Factors related to potential seasonal variations in HbA 1c levels in children have not been previously studied. ![]() However, most of the studies including paediatric age-groups had short observation periods or included relatively small groups of patients, or were not primarily concerned with analysis of seasonal HbA 1c fluctuations these reported relatively small differences in HbA 1c between the lowest and peak months. Such fluctuations were also observed in children with type 1 diabetes. Seasonal changes of HbA 1c levels have been described in several studies assessing populations of adult patients with type 1 and type 2 diabetes. The recent changes in the ADA criteria for the diagnosis of diabetes contribute to the importance of recognising any variation pertaining to HbA 1c levels, especially in those aged 7 years and older, as this is a key age interval for the diagnosis of type 1 diabetes mellitus in paediatric population. As HbA 1c measurement and patient self-monitoring of blood glucose are the two primary techniques used to assess the effectiveness of diabetes management, it is crucial to identify any factors that can bias these values. It is a measure of glycaemic control commonly used as a predictor of diabetic microvascular complications in people with type 1 and type 2 diabetes. Glycated haemoglobin A 1c (HbA 1c), which is formed through the non-enzymatic glycation of haemoglobin, is used as a cumulative estimate of mean blood glucose levels from the preceding 5–12 weeks in healthy people and in patients with diabetes. They may potentially affect the results of clinical trials using HbA 1c levels as their primary outcome, as well as HbA 1c-based diagnosis of diabetes. Seasonal changes of HbA 1c levels in schoolchildren with type 1 diabetes are a significant phenomenon and should be considered in patient education and diabetes management. Strong negative correlations of HbA 1c with ambient temperature ( R = −0.56 p = 0.0002), hours of sunshine ( R = −0.52 p = 0.0007) and solar irradiance ( R = −0.52 p = 0.0006) were present in schoolchildren, but not in preschoolers ( p ≥ 0.29 for each correlation). Autocorrelation analysis of HbA 1c levels in schoolchildren showed a sine-wave pattern with a cycle length of roughly 12 months, which mirrored changes in ambient temperature. The lowest HbA 1c levels were observed in late summer and the highest in winter months, with differences consistently exceeding 0.44%. ![]() ![]() Mean (±SD) HbA 1c level for the whole study period was 7.65 ± 1.12%. ResultsĪ total of 3,935 HbA 1c measurements in 589 school (≥7 years) and 88 preschool (<7 years) children were analysed. After comparison of autocorrelation patterns, patterns of metabolic control and meteorological data were evaluated using Spearman rank correlation. HbA 1c changes over more than 3 years were evaluated in type 1 diabetic patients who were younger than 18 years and had diabetes duration of more than 12 months, and correlated with measures of weather conditions (ambient temperature, hours of sunshine and solar irradiance). We evaluated seasonal HbA 1c changes in children with type 1 diabetes and its relation with measures of weather conditions. ![]()
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