Nationwide reduction in the frequency of severe XXXX by half.

@entity1 @entity6 @entity4053
AIMS: To examine contemporary rates of severe @entity4053 (SH) and identify the effect of predictors of SH in a pediatric type 1 @entity6 population. METHODS: The national @entity6 register provided data on @entity1 residing in Denmark from 2008 to 2013 in this register-based population study. Robust Poisson regression models were applied. RESULTS: The study population [n  =  2,715 (50.9  % @entity1 ), mean (SD) age at onset; 8.1 (4.0) years, @entity6 duration; 5.6 (4.9) years] comprised 7,390 @entity1 -years of data and 561 events of SH. The overall incidence of SH was 7.6 per 100 @entity1 -years. The incidence rate peaked with 16.0 per 100 @entity1 -years in 2008 reaching a nadir of 4.9 in 2011. Overall, insulin pump reduced the rate of SH with 27  % compared to any pen treatment (P  =  0.003). When stratifying pen treatment, premixed insulin increased the rate of SH by 1.9-fold (P  =  0.0015) and NPH increased the rate by 1.6-fold (P  =  0.003) versus pump treatment, whereas long-acting insulin analogues were comparable with pump treatment (P  =  0.1485). We found no association of SH with glycemic control (P  >  0.05). CONCLUSIONS: A nationwide halving in rates of severe @entity4053 was observed during the study period independent of the prevailing average HbA1c level. Changes in @entity6 care and successful educational programs may have influenced the lower incidence rate of severe @entity4053 .
