Factors Associated With Achieving Target A1C in Children and Adolescents With Type 1 Diabetes: Findings From the T1D Exchange Quality Improvement Collaborative

Demeterco-Berggren, Carla; Ebekozien, Osagie; Noor, Nudrat; Rompicherla, Saketh; Majidi, Shideh; Jones, Nana‐Hawa Yayah; McDonough, Ryan; Odugbesan, Ori; Kim, Ahlee; Izquierdo, Roberto; Kamboj, Manmohan K.; Jacobsen, Laura M.

doi:10.2337/cd22-0073

Cited by 18 publications

(2 citation statements)

References 37 publications

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“…In USA, in the context of the T1D exchange registry, data from 2017 to 2022 relative to 16 pediatric clinics and 25383 children and adolescents (up to 18 years of age) with a type 1 diabetes duration < 1 year were analyzed (mean age 13.3 years, mean diabetes duration 8 years) [ 25 ]. Overall, 18% of the patients had HbA1c < 7%, 44% had HbA1c levels between 7 and 9%, and 38% had HbA1c levels over 9%.…”

Section: Discussionmentioning

confidence: 99%

Continuous improvement of quality of care in pediatric diabetes: the ISPED CARD clinical registry

Nicolucci,

Graziano,

Lombardo

et al. 2024

Acta Diabetol

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Aim In Italy, the ISPED CARD initiative was launched to measure and improve quality of care in children and adolescents with type 1 diabetes. Methods Process and outcome indicators and the related information derived from electronic medical records were identified. A network of pediatric diabetes centers was created on a voluntary basis. Results Overall, 20 centers provided data on 3284 patients aged < = 18 years. HbA1c was monitored ≥ 2/year in 81.2% of the cases. BMI was monitored ≥ 1/year in 99.0%, lipid profile in 45.3%, and blood pressure in 91.7%. Pubertal status, albuminuria, eye examination, and screening of celiac disease and thyroiditis were underreported. From 2017 to 2021, average HbA1c levels decreased from 7.8 ± 1.2 to 7.6 ± 1.3%, while patients with LDL cholesterol > 100 mg/dl increased from 18.9 to 36.7%. Prevalence of patients with elevated blood pressure and BMI/SDS values also increased. In 2021, 44.7% of patients were treated with the newest basal insulins, while use of regular human insulin had dropped to 7.7%. Use of insulin pump remained stable (37.9%). Conclusions This report documents the feasibility of the ISPED CARD initiative and shows lights and shadows in the care provided. Improving care, increasing number of centers, and ameliorating data recording represent future challenges.

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Section: Discussionmentioning

confidence: 99%

Continuous improvement of quality of care in pediatric diabetes: the ISPED CARD clinical registry

Nicolucci,

Graziano,

Lombardo

et al. 2024

Acta Diabetol

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“…The combination of these physiological changes with the psychosocial challenges of the late teenage and early emerging adult periods leads to significantly higher blood sugars. In data from 2017-2022, only 17.7% of 13-18-year-olds and 17.4% of 19-25-year-olds were meeting the A1c target of <7.0% ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 97%

Transition to self-management among emerging adults with type 1 diabetes: a mixed methods study

Vitale,

Asher,

Shank

et al. 2024

Front. Clin. Diabetes Healthc.

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IntroductionEmerging adulthood is challenging for young people with type 1 diabetes (T1D). This study evaluated transition to diabetes self-management and perceptions of care transfer using mixed methods.MethodsAn online survey queried demographics, management characteristics, diabetes knowledge, self-care readiness, adherence, and diabetes distress. T-tests compared survey scores between those with self-reported target A1c <7.0% versus ≥7.0%. Pearson correlations assessed associations between A1c and diabetes distress, stratified by A1c <7.0% versus ≥7.0%. Qualitative semi-structured interviews elicited perceptions of young adults; transcripts were analyzed using directed qualitative content analysis.ResultsOf 141 participants (30% male, 84% non-Hispanic white) completing the survey, 41% self-reported target A1c <7.0%. Diabetes knowledge and self-care readiness scores did not differ between those with A1c <7.0% versus ≥7.0%, while diabetes distress was lower (45 ± 20 vs 52 ± 20, p=0.01) and adherence higher (77 ± 12 vs 71 ± 14, p=0.02) in those with A1c <7.0% versus ≥7.0%. Diabetes distress was significantly associated with glycemic outcomes in those reporting A1c ≥7.0% (R=0.36, p<0.01). Qualitative analysis (24 participants) revealed five themes and two sub-themes, notable for need for more mental health support, support from others with T1D, benefits of technology for care autonomy, and challenges of obtaining diabetes supplies.DiscussionEmerging adults with self-reported target A1c endorsed lower diabetes distress and higher adherence than those with elevated A1c. Mental health access, support from others with T1D, technology use, and guidance for supply acquisition may improve transition to self-management and care transfer for emerging adults with T1D.

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A randomized controlled clinical trial to improve health outcomes in youth with type 1 diabetes: Study design and baseline characteristics

O'Donnell

Trojanowski

Alonso

et al. 2023

Contemporary Clinical Trials

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Factors Associated With Achieving Target A1C in Children and Adolescents With Type 1 Diabetes: Findings From the T1D Exchange Quality Improvement Collaborative

Cited by 18 publications

References 37 publications

Continuous improvement of quality of care in pediatric diabetes: the ISPED CARD clinical registry

Continuous improvement of quality of care in pediatric diabetes: the ISPED CARD clinical registry

Transition to self-management among emerging adults with type 1 diabetes: a mixed methods study

A randomized controlled clinical trial to improve health outcomes in youth with type 1 diabetes: Study design and baseline characteristics

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