Communication frequency between visits is associated with improved glycemic control in pediatric diabetes

Abstract

ObjectivesChildren with diabetes are advised to see their diabetes team every 3 months, with interim communication to address insulin dose adjustments. Despite increasing digital accessibility, there is limited data on whether provider–patient communication frequency is associated with glycemic control in pediatric diabetes. We assessed patterns of communication between diabetes clinic visits and whether communication frequency via electronic messaging (EM) and telephone was associated with glycemic control in pediatric diabetes.MethodsRetrospective chart review of 267 children with type 1 (T1DM) and type 2 diabetes (T2DM) over a 1-year period (July 2018–June 2019) at an urban academic pediatric diabetes center. Association between frequency of communication (via EM and telephone) and HbA1c was analyzed using regression analysis.ResultsOf 267 participants, 224 (84%) had T1DM, 43 (16%) had T2DM, mean age 11.6 years (SD 4), mean duration of diabetes 3.5 years (SD 3.4), and mean HbA1c 73.8 ± 23 mmol/mol (8.9 ± 2.2%). Most participants (82%) communicated with their diabetes team at least once per year, with a mean number of overall communications of 10.3 ± 13.6 times. Communications were via EM (48%), phone (40%), or both (53%). Participants with more frequent communication had lower HbA1c values (p=0.007), even when controlling for age, sex, provider, and number of clinic visits per year. We determined that a threshold of three communications per year was associated with a lower HbA1c (p=0.006).ConclusionsMore frequent communication with the diabetes team between visits is associated with improved glycemic control. Initiatives to contact diabetes patients between clinic visits may impact their overall glycemic control.

Size matters: Influence of center size on quality of diabetes control in children and adolescents with type 1 diabetes—A longitudinal analysis of the DPV cohort

“…A factor related to worse outcome of “XS”‐centers could be the frequency of patient visits per year, which was lowest in “XS”‐centers. Even though “XS” centers provided more visits than recommended in international and national guidelines, there is evidence that patients with poor metabolic control benefit from a higher frequency of contacts 33,34 . Even “XL”‐centers with higher patient volumes provided more yearly visits per patient than recommended in international guidelines.…”

The importance of multidisciplinary and family support in children with Type 1 Diabetes Mellitus: an integrative review

“…Logo, visitas domiciliares frequentes pela equipe multiprofissional são alternativas para aqueles que não são usuários de tecnologia. É importante, então, adaptar as abordagens de comunicação às populações mais afetadas pelos determinantes sociais da saúde (Verma et al, 2020).…”