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Observational Study
. 2023 Sep;17(5):1243-1251.
doi: 10.1177/19322968221096423. Epub 2022 May 12.

Patterns and Predictors Associated With Long-Term Glycemic Control in Pediatric and Young Adult Patients with Type 1 Diabetes

Johan Jendle  1 , Björn Agvall  2 , Alexander Galozy  3 , Peter Adolfsson  1   4
Affiliations
Observational Study

Patterns and Predictors Associated With Long-Term Glycemic Control in Pediatric and Young Adult Patients with Type 1 Diabetes

Johan Jendle et al. J Diabetes Sci Technol. 2023 Sep.

Abstract

Background: The development of diabetes technology is rapid and requires education and resources to be successfully implemented in diabetes care management.

Method: In an observational study, we evaluated the use of advanced diabetes technology, resource utilization, and glycemic control. The study population was 725 individuals with type 1 diabetes (T1D) living in Region Halland, Sweden. The study cohort was followed for 7 years between 2013 and 2019.

Results: Children aged 0 to 17 years were associated with significantly better glucose control than young adults aged 18 to 25 years. The mean HbA1c in children and young adults was 53 mmol/mol (7.0%) compared to 61 mmol/mol (7.7%) (P < .0001), respectively. Comorbidities such as attention deficit hyperactivity disorder (ADHD), autism, and coelic disease were associated with higher HbA1c. All groups, regardless of age and comorbidity, showed a positive effect on glucose control after visiting a dietitian or psychologist. Differences were found between the age groups in terms of more use of advanced diabetes technology and more frequent visits to a physician in children compared to young adults.

Conclusions: More frequent visits to physicians, and a visit to dietitians, and psychologists were associated with improved glucose control in individuals with T1D 0 to 25 years. Increased resources, including access to more advanced technologies, may be required in young adults with T1D.

Keywords: CGM; diabetes management; diabetes technology; type 1 diabetes.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The mean HbA1c for each year of the study period for the pediatric population (light gray) and for the young adults (dark gray). Patients with index for diabetes diagnosis before 2013 and/or diabetes duration <3 months are excluded. Error bars show 95% confidence interval for the mean HbA1c values.
Figure 2.
Figure 2.
Proportion of individuals, pediatric and young adults, reaching HbA1c <57 mmol/mol 1 year after diabetes diagnosis.
Figure 3.
Figure 3.
Change in HbA1c after visit to dietician. Mean difference (SD) in HbA1c -11.1 (19.1) mmol/mol and -16.2 (26.6) mmol/mol in individuals 0 to 17 years and 18 to 25 years respectively.
Figure 4.
Figure 4.
Change in HbA1c after visit to psychologist. Mean difference (SD) in HbA1c after visit -9.25 (24.9) mmol/mol and -6.21 (21.7) mmol/mol in individuals 0 to 17 years and 18 to 25 years respectively.
See this image and copyright information in PMC

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