ISSN: 1308-5727 | E-ISSN: 1308-5735
Volume : Issue : Year : 2024
Forms

Abstracting & Indexing
Turkish Society for Pediatric Endocrinology and Diabetes
Characteristics of Children with Type 1 Diabetes and Persistent Suboptimal Glycemic Control [J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. 2012; 4(2): 82-88 | DOI: 10.4274/Jcrpe.663

Characteristics of Children with Type 1 Diabetes and Persistent Suboptimal Glycemic Control

Hyuntae Kim1, Angelo Elmi1, Celia L. Henderson1, Fran R. Cogen1, Paul B. Kaplowitz1
George Washington University School Of Public Health And Health Services, Department Of Epidemiology And Biostatistics, Washington, D.C., Usa

Objective: This study aims to determine the relationship between the duration of persistent poor glycemic control in type 1 diabetes mellitus (T1DM) children and the likelihood of subsequent improvement.
Met­hods: A retrospective cohort study was conducted on T1DM patients aged 6-18 years, followed for at least six visits at Children’s National Medical Center (Washington, DC) with at least one hemoglobin A1c (HbA1c) ?10% after the first year since the initial visit (n=151). Medical records of patients with subsequently improved glycemic control were reviewed (n=39).
Re­sults: Patients aged 12-18 years, females, and Medicaid patients were twice as likely to be in persistently poor control as patients aged 6-11 years, males, and privately insured patients, respectively. Each additional visit with HbA1c ?10% and one percentage point increase in the mean HbA1c reduced the likelihood of subsequent improvement by 20% and 50%, respectively. Of the 39 patients with improved control, only 5 (13%) sustained their improvement for ?2 years. Multiple contributing factors for improved control were identified, but no one factor explained improved control in >25% of patients.
Conc­lu­si­on: This study suggests that the longer the duration of poor control, the more difficult it is to reverse the underlying factors of poor diabetes management. Strategies to improve regular clinic attendance along with reinforcement of changes which resulted in improved control are critical. Adolescents, females, and Medicaid patients in particular should be targeted for sustained intervention.

Keywords: type 1 diabetes mellitus,glycosylated hemoglobin,glycemic control,children

Hyuntae Kim, Angelo Elmi, Celia L. Henderson, Fran R. Cogen, Paul B. Kaplowitz. Characteristics of Children with Type 1 Diabetes and Persistent Suboptimal Glycemic Control. J Clin Res Pediatr Endocrinol. 2012; 4(2): 82-88
Manuscript Language: English
LookUs & Online Makale