Australia Study: Kids With T1D Seeing Major Gains Worldwide

Australian-Led Global Study Finds Dramatic Improvements in Children's Type 1 Diabetes Control

A study from Australia, led by researchers at the Lyell McEwin Hospital in Adelaide, has delivered some of the most comprehensive and encouraging data ever collected on how children with type 1 diabetes (T1D) are managing their condition worldwide. Published in The Lancet Diabetes & Endocrinology in 2025, this landmark analysis tracked more than 100,000 children across nine international diabetes registries — including the United States — over a ten-year period from 2013 to 2022.

What Makes This International Perspective Valuable?

Because this study pulled data from eight countries and one international initiative — including the American T1D Exchange Quality Improvement Collaborative — U.S. families can see exactly how their children's outcomes stack up against peers in Australia, Sweden, Norway, Denmark, Germany, the Czech Republic, and England and Wales. It's a rare, honest global report card on pediatric T1D care, and the findings carry direct relevance for American parents and clinicians.

Key Findings: Blood Sugar Control Is Getting Better

The most headline-worthy result: average HbA1c across all registries dropped meaningfully over the decade. In 2013, the pooled average HbA1c was 8.2% (approximately 186 mg/dL average blood glucose). By 2022, that had fallen to 7.6% (roughly 171 mg/dL). Even more striking, the share of children reaching the international target of below 7.0% (below approximately 154 mg/dL average) nearly doubled — rising from 19.0% to 38.8%.

For context, the American Diabetes Association (ADA) currently recommends an HbA1c target of below 7.0% for most children with T1D, aligning with the International Society for Pediatric and Adolescent Diabetes (ISPAD) 2022 guidelines. The good news is that more kids are hitting that mark. The sobering reality: more than 61% of children worldwide still are not.

Technology Is Leading the Way

The data make clear that diabetes technology is driving improvement. Insulin pump use rose from 42.9% to 60.2% of children over the study period. Even more dramatic, continuous glucose monitor (CGM) use skyrocketed from just 18.7% in 2016 to 81.7% in 2022. These devices give children and families real-time blood sugar data and automated insulin delivery options that simply didn't exist a generation ago.

Fewer Dangerous Emergencies

The safety news is equally encouraging. Severe hypoglycemia (dangerously low blood sugar) rates dropped from 3.0 to 1.7 events per 100 person-years. Diabetic ketoacidosis (DKA) rates fell from 3.1 to 2.2 events per 100 person-years. This is particularly reassuring because lower HbA1c targets sometimes raise fears of more low blood sugar episodes — this study shows that with modern technology, you can aim lower and still be safer.

Why This Matters for US Patients

American children with T1D are part of this global story. The U.S. T1D Exchange data contributed to these findings, meaning this isn't just a foreign benchmark — it reflects American children too. For U.S. families, this study confirms that pushing for CGM and pump access isn't optional; it's central to better outcomes. It also signals that even with the best technology available, the majority of children still need additional support to reach recommended targets. Advocating for access to newer automated insulin delivery systems and consistent specialist care remains critical. If your child's HbA1c is above 7.0%, you are in the majority globally — but the gap is closing, and the tools to close it further are available now.

Original Study Citation

Zimmermann, Lanzinger, Kummernes, et al. "Treatment regimens and glycaemic outcomes in more than 100,000 children with type 1 diabetes (2013–22): a longitudinal analysis of data from paediatric diabetes registries." The Lancet Diabetes & Endocrinology, 2025. DOI: 10.1016/S2213-8587(24)00279-1. PMID: 39622257.