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Do eating behaviors in the general population account for country variance in glycemic control among adolescents with diabetes: the Hvidoere Study Group and the Health Behaviour in School-Aged Children study


Due, P and de Beaufort, C and Trab Damsgaard, M and Mortensen, HB and Rasmussen, M and Ahluwalia, N and Skinner, TC and Swift, P and Aanstoot, H-J and Aman, J and Neu, JA and Barrett, TG and Castano, L and Chiarella, F and Daneman, D and Danne, T and Dorchy, H and Fisher, LK and Hoey, H and Kaprio, EA and Kocova, M and Njolstad, PR and Phillip, M and Robert, J-J and Robertson, KJ and Schonle, EJ and Skovlund, SE and Urakami, T and Vanelli, M and Cameron, F and Aasvee, K and Albayrak Kaymak, D and Alexandrova, B and Alexandrova-Karamanova, A and Alikasifoglu, M and Amit, S and Andersen, A and Andrei, L and Archimi, A and Arnarsson, AM and Arnold, P and Augustine, L and Augustson, L and Baban, A and Babloyan, A and Bacher, E and Balakireva, O and Balazsi, R and Baska, T and Baskova Peter Kolarcik, M and Bendtsen, P and Berg, C and Bilz, L and Bletsch, A and Bobakova, D and Boe Rayce, S and Bogdanova, E and Bondar, T and Boniel-Nissim, M and Borracino, A and Bosakova, L and Bregu, A and Brindova, D and Brooks, F and Bucksch, J and Burazeri, G and Callaghan, M and Camacho, I and Cavallo, F and Chester, K and Churganov, O and Clement, C and Corell, M and Cosma, A and Craig, W and Currie, C and Currie, D and Dalmasso, P and Damian, LE and Danielsson, U and Dankulincova Veselska, Z and Davison, C and De Clercq, B and de Looze, M and De Roos, SA and del Carmen Granado Alcon, M and Delgrande Jordan, M and Dimitrova, E and Donnelly, P and Due, P and Dur, W and Dzielska, A and Ehlinger, V and Elgar, F and Ercan, O and Erginoz, E and Eriksson, C and Farrugia, J and Felder-Puig, R and Ferreira, M and Finne, E and Fletcher, A and Foteva Manevska, T and Fotiou, A and Fox, KA and Frasquilho, D and Freeman, J and Gabhainn, SN and Garcia Moya, I and Gaspar, T and Gaspar de Matos, M and Gauci, C and Gavin, A and Gavrilov, D and Gavrilova, E and Georgievska-Nanevska, E and Giacchi, M and Gobina, I and Godeau, E and Godin, I and Gommans, R and Grinberga, D and Gunnthorsdottir, H and Hagquist, C and Hamrik, Z and Harel-Fisch, Y and Hartley, J and Hemen, M and Hewitt, G and Hjalmsdottir, A and Hocevar, T and Hofmann, F and Holstein, B and Holubcikova, J and Honkala, E and Honkala, S and Hublet, A and Hyska, J and Iannotti, R and Inchley, J and Ishoy Michelsen, S and Janssen, I and Jericek, H and Jiminez-Iglesias, A and Kallay, E and Kalman, M and Kasapinov, B and Katreniakova, Z and Kelly, C and Kenny, U and King, M and Klemera, E and Klinger, D and Klocke, A and Kokkevi, A and Kokonyei, G and Kolip, P and Kollarova, J and Kolto, A and Kopcakova, J and Koprivnikar, H and Kosevska, E and Kostarova Unkovska, L and Kotzeva, T and Kowalewska, A and Krippler, S and Krolner, R and Kuntsche, E and Lager, ACJ and Lazzeri, G and Lenzi, M and Lesco, G and Liiv, K and Loefstedt, P and Loureiro, N and Lubel, S and Madarasova Geckova, A and Maes, L and Magnusson, J and Makransky, G and Malinowska-Cieslik, M and Malinowska-Szkutnik, A and Markkanen, I and Matochkina, A and Mayer, D and Mazur, J and Mazurova, N and Meilstrup, C and Melkumova, M and Melzer, W and Mihali, E and Molcho, M and Moor, I and Moreau, N and Moreno, C and Morgan, A and Morrison, B and Movseyan, Y and Music Milanovic, S and Nalecz, H and Negru, O and Nemeth, A and Ng, K and Niclasen, B and Nielsen, L and Nuutinen, T and Nygren, J and Ojala, K and Olafsson, K and Orkenyi, A and Osmani, S and Ottova-Jordan, V and Pagh Pedersen, T and Panayotova, Y and Pavelka, J and Pavic Simetin, I and Pavlova, D and Pejnovic Franelic, I and Petzold, M and Pickett, W and Piette, D and Piraccini, G and Poljicanin, T and Popescu, A-M and Pucelj, V and Pudule, I and Puhov, D and Qirjako, G and Quick, V and Rahic, B and Ramiro, L and Ramos, P and Rasmussen, M and Rathmann, K and Ravens-Sieberer, U and Reis, M and Rhodes, G and Riaz, Y and Rich Madsen, K and Richter, M and Rivera, F and Roberts, C and Rossi, S and Saewyc, E and Sallona, F and Samdal, O and Sanchez-Queija, I and Santos, T and Sargsyan, SG and Sarkova, M and Scagnetti, N and Schnohr, C and Sentenac, M and Shtainmetz, N and Sigmundova, D and Simoe, C and Smeeton, N and Smigelskas, K and Smith, R and Sovik, M and Spanu, F and Spencer, N and Stevens, G and Tabak, I and Tael, M and Taut, D and ter Bogt, T and Tesler, R and Teutsch, F and Thorsteinsson, E and Todorova, I and Tome, G and Torsheim, T and Trab Damsgaard, M and Tynjala, J and Uysal, O and Vaiciunas, T and Valimaa, R and Van der Sluijs, W and van Dorssalaer, S and Varnai, D and Vasileva, L and Velika, B and Vereecken, C and Vieno, A and Villerusa, A and Vladu, C and Vollebergh, WAM and Wagener, Y and Walsh, P and Walsh, SD and Whitehead, R and Wickman Henriksen, P and Windlin, B and Woynarowska, B and Young, H and Zaborskis, A and Zsiros, E and Zupanic, T, Do eating behaviors in the general population account for country variance in glycemic control among adolescents with diabetes: the Hvidoere Study Group and the Health Behaviour in School-Aged Children study, Pediatric Diabetes, 14, (8) pp. 554-561. ISSN 1399-543X (2013) [Refereed Article]

Copyright Statement

2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

DOI: doi:10.1111/pedi.12038


Background: The Hvidoere Study Group (HSG) has demonstrated major differences in glycemic control between pediatric diabetes centers which remain largely unexplained. This study investigates whether these differences are partly attributable to healthy eating norms in the background population.

Methods: The study involved adolescents from 18 countries from (i) the Health Behaviour in School-Aged Children study (HBSC) and (ii) the HSG. There were 94 387 participants from representative HBSC samples of 11-, 13- and 15-yr-olds and 1483 11- to 15-yr-old adolescents with diabetes from the HSG. The frequency of intake of fruit, vegetables, sweets, sugary soft drinks, and daily breakfast was compared between the two groups. The glycemic control of the adolescents in the HSG cohort was determined by measuring glycated hemoglobin (HbA1c).

Results: Across countries in the HSBC survey, there was substantial variation in prevalence of healthy eating behavior and even greater variation between adolescents from the HSG centers. In all countries more adolescents with diabetes reported healthy eating behavior compared to national norms. In individuals healthy eating behavior had a significant effect on the individual level HbA1c. There was no significant correlation between the frequencies of these healthy eating behaviors at (i) the national level and (ii) diabetes center level and the center mean HbA1c.

Conclusions: Although individual healthy eating behavior is associated with better glycemic control at the individual level, such eating behavior does not explain the center differences in HbA1c. Similarly, the reported healthy eating norm of the background populations does not explain the variation in glycemic control among centers.

Item Details

Item Type:Refereed Article
Keywords:adolescents, behavior, comparative study, diabetes mellitus type 1, eating
Research Division:Biomedical and Clinical Sciences
Research Group:Paediatrics
Research Field:Paediatrics not elsewhere classified
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Skinner, TC (Professor Timothy Skinner)
ID Code:91446
Year Published:2013
Web of Science® Times Cited:3
Deposited By:Rural Clinical School
Deposited On:2014-05-20
Last Modified:2014-06-06

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