Glycemic Control in Youth with Diabetes: The SEARCH for Diabetes in Youth Study

Abstract

Objective To assess correlates of glycemic control in a diverse population of children and youth with diabetes. Study design This was a cross-sectional analysis of data from a 6-center US study of diabetes in youth, including 3947 individuals with type 1 diabetes (T1D) and 552 with type 2 diabetes (T2D), using hemoglobin A1c (HbA1c) levels to assess glycemic control. Results HbA1c levels reflecting poor glycemic control (HbA1c ≥ 9.5%) were found in 17% of youth with T1D and in 27% of those with T2D. African-American, American Indian, Hispanic, and Asian/Pacific Islander youth with T1D were significantly more likely to have higher HbA1c levels compared with non-Hispanic white youth (with respective rates for poor glycemic control of 36%, 52%, 27%, and 26% vs 12%). Similarly poor control in these 4 racial/ethnic groups was found in youth with T2D. Longer duration of diabetes was significantly asso*ciated with poorer glycemic control in youth with T1D and T2D. Conclusions The high percentage of US youth with HbA1c levels above the target value and with poor glycemic control indicates an urgent need for effective treatment strategies to improve metabolic status in youth with diabetes.

Transition From Pediatric to Adult Care for Youth Diagnosed With Type 1 Diabetes in Adolescence

“…Previous research has suggested that African American and Hispanic youth are at risk for poor glycemic control while in pediatric care, although some studies have found that socioeconomic variables account for this effect. 7,17,18 Young adults from minority racial/ethnic backgrounds are considered at increased risk of poor transition outcomes. 19 Given our findings, this warrants further evaluation in future studies.…”

“…1,2,[4][5][6] Glycemic control, critical to long-term optimal outcomes for diabetes, has been shown to be poor for many youth as they age into adulthood. [7][8][9][10] Many agerelated factors could contribute to poor glycemic control, including changes in biological and psychosocial factors, and changes in access to care. 4,5 More specifically, the impact of age-related changes in diabetes care providers on glycemic control is not well understood.…”

Lower Frequency of Insulin Pump Treatment in Children and Adolescents of Turkish Background with Type 1 Diabetes: Analysis of 21,497 Patients in Germany

“…Socioeconomic status has been found to explain a large part of differences between children with and without migration background. 2,5,16 However, we adjusted for several environmental residence-based socioeconomic conditions without any change of our main finding. Ecological bias may be present with respect to ecological variables.…”

“…[1][2][3][4] In Germany in particular, people with Turkish background, the largest ethnic minority, have been found to have poor health outcomes. [5][6][7] As possible reasons for lower acceptance of prevention and treatment offers, language barriers, lower socioeconomic status, another disease belief, or, on the other hand, factors within the healthcare system have been discussed.…”

Challenges of emerging adulthood-transition from paediatric to adult diabetes

“…Achievement of target glycaemia in the young adolescent group can be challenging with large studies reporting less than one-third achieving the recommended glycaemic targets [17] . The glycaemic control in the two clinical settings was assessed as part of an internal audit done at our centre.…”