RESEARCH – August 2025

Treatment Options and Results for Type 1 Diabetes Patients at Tallinn Children’s Hospital in 2023

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Abstract

Background. Type 1 diabetes (T1D) is characterised by the chronic immune-mediated destruction of pancreatic β-cells, leading to absolute insulin deficiency. The risk of development and progression of complications depends on glycaemic control. According to the guidelines of the International Society for Pediatric and Adolescent Diabetes, the childhood goal of treatment is glycated haemoglobin (HbA1c) levels below 7.0%.
Objectives. To determine and evaluate the current situation of childhood T1D patient care options and results in Tallinn Children’s Hospital.
Methods. A retrospective analysis of medical records of T1D patients in Tallinn Children’s Hospital was conducted. Multiple logistic regression was used to explore associations between glycaemic control and patients’ characteristics. HbA1c levels were averaged over the course of a year.
Results. The total number of analysed patients was 607, 335 (55.2 %) of whom were boys. 2% of patients were 0–4 yrs.; 17.8% were 5–9 yrs.; 35.4% were 10–14 yrs. and 44.8 % were 15–19 yrs. 70.7% of patients were on insulin pump therapy and 29.3 % on multiple injection therapy. 91.9% patients used a continuous glucose monitoring system. The Minimed 780G hybrid pump was the most commonly used insulin pump, in use by 31 % of all subjects.
During the observation period, the median HbA1c level was 7.6 %. The target HbA1c of < 7 % was achieved by 26 % of patients, while poor metabolic control (HbA1c ≥ 8.5%) was observed in 26 % of subjects. Optimal glycaemic control (HbA1c ≤ 7.5%) was associated with younger age, lower body mass index, and sensor use (p < 0.01 for all). Compared to injection therapy, Minimed 640/740G users had a significantly lower chance of achieving optimal glycaemic control (OR 0.35; 95% CI 0,20-0,60).
Summary. Based on one year of data collected from a single centre, the treatment outcomes for children and adolescents are relatively successful. Establishing a national diabetes registry in Estonia would be beneficial for more consistent assessment of treatment outcomes.