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Characteristics of children with type 1 diabetes and persistent suboptimal glycemic control

Hyuntae Kim1, Angelo Elmi, Celia L Henderson

  • 1George Washington University School of Public Health and Health Services, Department of Epidemiology and Biostatistics, Washington, DC 20010, USA.

Journal of Clinical Research in Pediatric Endocrinology
|June 8, 2012
PubMed

Insights

Persistent poor glycemic control in children with type 1 diabetes mellitus (T1DM) makes improvement difficult. Longer duration of poor control, particularly in adolescents, females, and Medicaid patients, requires targeted interventions for sustained diabetes management.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Chronic Disease Management

Background:

  • Persistent poor glycemic control in children with type 1 diabetes mellitus (T1DM) poses significant long-term health risks.
  • Understanding factors influencing the reversibility of poor glycemic control is crucial for effective T1DM management.

Purpose of the Study:

  • To investigate the relationship between the duration of persistent poor glycemic control and the likelihood of subsequent improvement in pediatric T1DM patients.
  • To identify demographic and clinical factors associated with sustained glycemic control improvement.

Main Methods:

  • Retrospective cohort study of 151 T1DM patients (aged 6-18 years) with at least one HbA1c ≥ 10% after the first year.
  • Review of medical records for 39 patients who demonstrated subsequent improvement in glycemic control.

Main Results:

  • Older age (12-18 years), female sex, and Medicaid insurance were associated with a higher likelihood of persistently poor glycemic control.
  • Each additional visit with HbA1c ≥ 10% decreased improvement likelihood by 20%; a 1-point increase in mean HbA1c reduced it by 50%.
  • Only 13% of patients with improved control sustained it for ≥ 2 years; no single factor explained improvement in >25% of cases.

Conclusions:

  • The duration of poor glycemic control in pediatric T1DM is a significant barrier to achieving sustained improvement.
  • Strategies enhancing regular clinic attendance and reinforcing positive management changes are vital.
  • Adolescents, females, and Medicaid patients require targeted interventions to address challenges in diabetes management.
Abstract

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