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Targets and teamwork: Understanding differences in pediatric diabetes centers treatment outcomes

Timothy C Skinner1, Karin S Lange2, Hilary Hoey3

  • 1School of Psychological and Clinical Sciences, Charles Darwin University, Darwin, Northern Territory, Australia.

Pediatric Diabetes
|November 22, 2017
PubMed

Insights

Diabetes care teams’ shared goals and expectations influence parental targets, impacting metabolic control in children with type 1 diabetes. This study highlights the importance of team cohesion for better pediatric diabetes outcomes.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Significant variations exist in metabolic control among pediatric diabetes centers globally.
  • The underlying reasons for these center-specific differences in outcomes remain largely undetermined.
  • Understanding these factors is crucial for improving treatment efficacy and patient care.

Purpose of the Study:

  • To investigate the extent to which healthcare professionals' targets and expectations influence center-specific differences in metabolic outcomes for children with type 1 diabetes.
  • To explore the relationship between care team perspectives, parental targets, and patient hemoglobin A1c (HbA1c) levels.
  • To identify factors contributing to disparities in pediatric diabetes care quality.

Main Methods:

  • Cross-sectional study involving 1113 children (under 11) with type 1 diabetes from 18 centers in 17 countries.
  • Data collection included clinical, demographic information, and blood samples for HbA1c assay.
  • Questionnaires assessed treatment targets and monitoring frequency for parents and healthcare professionals.

Main Results:

  • Mean HbA1c levels varied substantially across centers, from 7.3% to 8.9%.
  • Centers with lower mean HbA1c featured parents reporting lower targets, healthcare professionals reporting lower targets and more frequent testing, and greater team agreement on targets.
  • Higher team-reported HbA1c targets and target disagreement correlated with higher parental-reported targets, partially explaining center differences.

Conclusions:

  • The cohesiveness and perspectives of pediatric diabetes care teams significantly influence parental treatment targets.
  • These team dynamics contribute to observed differences in metabolic outcomes among pediatric diabetes centers.
  • Optimizing team communication and target alignment may improve pediatric diabetes care quality.
Abstract

Keywords:
childrenhealth service deliverytreatment targets

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