The Relationship between Self-Management and Glycemic Control in a Cohort of Children with Type 1 and Type 2 Diabetes

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Luisa M Rodriguez1, Krishnavathana V Hassan1, Jeffrey Rhodes1

  • 1Department of Pediatric Endocrinology and Metabolism, Texas Children's Hospital, Baylor College of Medicine, USA.

Journal of Diabetes & Metabolism
|September 27, 2014
PubMed

Insights

A new clinic preparedness score tool showed that better self-management in type 1 diabetes (T1DM) correlates with improved glycemic control (HbA1C). This tool and its findings were less clear for type 2 diabetes (T2DM) in children.

Area of Science:

  • Pediatric Endocrinology
  • Diabetes Self-Management
  • Clinical Assessment Tools

Background:

  • Effective diabetes self-management is crucial for improving glycemic control.
  • Objective tools are needed in clinical settings to assess patient preparedness and adherence.
  • Existing methods may not fully capture the nuances of self-management across different diabetes types.

Purpose of the Study:

  • To develop and validate a clinic preparedness score for assessing diabetes self-management in pediatric patients.
  • To evaluate the correlation between clinic preparedness, adherence behaviors, and glycemic control (HbA1C) in type 1 diabetes (T1DM) and type 2 diabetes (T2DM).
  • To compare clinician perceptions of patient adherence with objective measures.

Main Methods:

  • A 23-question clinic preparedness tool was administered to 350 T1DM and 137 T2DM pediatric patients and their families.
  • HbA1C levels were correlated with parameters like glucose meter availability, hypoglycemia preparedness, and blood glucose logging.
  • Clinician perceptions of patient adherence and dose adjustments were also surveyed.

Main Results:

  • T1DM patients with higher clinic preparedness scores exhibited lower HbA1C levels (8.2% vs. 9.4%).
  • Parental involvement and insulin dose adjustments in T1DM were associated with better glycemic control.
  • Clinicians accurately predicted glycemic control based on reported dose adjustments, though similar correlations were not found for T2DM.

Conclusions:

  • Clinic preparedness appears to be a significant factor in achieving better glycemic control for pediatric T1DM.
  • Adherence measures and self-management characteristics differ between pediatric T1DM and T2DM.
  • Variability in glucose monitoring and medication administration may impact T2DM management distinctively compared to T1DM.
Abstract

Keywords:
Glycemic controlHbA1CInsulinType 1 diabetesType 2 diabetes

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