Clinic attendance and health outcomes of youth with type 2 diabetes mellitus

Abstract

This study assessed whether clinic attendance was related to health outcomes for youth with type 2 diabetes mellitus (type 2 DM). Medical records of pediatric patients with type 2 DM were retrospectively reviewed. Clinic attendance was much more infrequent than recommended by physicians, and 42% of the sample withdrew from medical care. Patients who had a history of not showing during appointments had higher HbA1c levels than those who attended regularly scheduled visits; however, contrary to our hypotheses, average number of clinic visits was not associated with HbA1c levels or zBMI. Given the increased risk for health complications, new strategies are needed to keep patients engaged with medical care.

A cross‐sectional study of non‐attendance among patients at a US hemophilia treatment center 2010‐2014

“…Other studies that considered race among adult populations found similar significant associations . However, race was not significantly associated with attendance in paediatric populations attending diabetes clinics . This differs from our results, which showed an impact of black race on non‐attendance even after limiting to patients <18 years old and controlling for demographic, clinical and insurance characteristics.…”

“…A US study among adults with HIV reported strikingly similar findings (aOR: 2.09; 95% CI: 1.10‐3.96) . However, in 2 separate cohorts of children attending diabetes clinics in the United States, clinic non‐attendance did not significantly vary by insurance type . It is challenging to directly compare our findings regarding insurance to those of studies conducted in countries with single payer health systems.…”

“…Non‐attendance was associated with an increasing number of ED visits and hospitalizations in our study. Others have also shown associations between missed visits and poor health outcomes including mortality and worse glycaemic control . Although non‐attendance was associated with ED visits and hospitalizations in our HTC population, patients with non‐attended visits did attend other HTC visits during the time period.…”

“…Clinic attendance has been tied to health outcomes in other chronic disease populations. Among youth and adults with diabetes, frequent attendance at diabetes clinics is associated with increased survival and better glucose management (defined by lower HbA1c levels) . Further, patients who attend diabetes clinics feel they have some control over their disease .…”

Treatment adherence and BMI reduction are key predictors of HbA1c 1 year after diagnosis of childhood type 2 diabetes in the United Kingdom

“…It is a worry that 5% of cases did not attend any follow‐up after diagnosis, though significant loss to follow up has been described previously . Although a previous study has shown that clinic attendance and HbA1c are associated, we did not demonstrate this association in our study when we adjusted for other covariables. The challenge is engaging young people with T2DM in the diabetes clinical services and their management plan.…”