HbA1c tracking and bio-psychosocial determinants of glycaemic control in children and adolescents with type 1 diabetes: retrospective cohort study and multilevel analysis

Lawes, Timothy; Franklin, Victoria; Farmer, George

doi:10.1111/pedi.12100

Cited by 46 publications

(70 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other studies have also found correlations of glycemic control and household composition, with improved control in those patients whose parents are married and living together vs. single‐parent households . In our study, after regression analysis, there was no significant difference in the rate of single‐parent household between the officer and enlisted groups.…”

Section: Discussionsupporting

confidence: 48%

Glycemic control and sponsor rank of military dependents with type 1 diabetes mellitus

2015

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 48%

Glycemic control and sponsor rank of military dependents with type 1 diabetes mellitus

2015

View full text Add to dashboard Cite

show abstract

“…Habituation of the day to day approach to managing chronic disease can make any long-lasting change difficult [34]. Studies involving paediatric and adolescent individuals with type 1 diabetes indicate that age, sex, body mass index, socioeconomic factors, physical activity levels, frequency of glucose monitoring and personality traits can also influence temporal HbA 1c trends [16,[35][36][37]. It may be that a combination of these endogenous and exogenous factors contributes to the phenomenon of tracking and that both need to be addressed for effective long-term glycaemic control.…”

Section: Discussionmentioning

confidence: 99%

“…Crucially, previous reports [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] have largely examined individuals with pre-existing type 1 diabetes (i.e. not from the time of diagnosis).…”

Section: Introductionmentioning

confidence: 99%

Clinically meaningful and lasting HbA1c improvement rarely occurs after 5 years of type 1 diabetes: an argument for early, targeted and aggressive intervention following diagnosis

et al. 2018

View full text Add to dashboard Cite

Aims/hypothesis Our objectives were to explore whether the phenomenon of HbA 1c 'tracking' occurs in individuals with type 1 diabetes, how long after diagnosis does tracking take to stabilise, and whether there is an effect of sex and age at diagnosis on tracking. Methods A total of 4525 individuals diagnosed with type 1 diabetes between 1 January 1995 and 1 May 2015 were identified from The Health Improvement Network (THIN) database. Mixed models were applied to assess the variability of HbA 1c levels over time with random effects on general practices (primary care units) and individuals within practices. Results 4525 individuals diagnosed with type 1 diabetes were identified in THIN over the study period. The greatest difference in mean HbA 1c measurement (−7.0 [95% CI −8.0, −6.1] mmol/mol [0.6%]) was seen when comparing measurements made immediately after diagnosis (0-1 year since diagnosis) with those at 10 or more years (the reference category). The mean difference in HbA 1c for the successive periods compared with 10 or more years after diagnosis declined and was no longer statistically significant after 5 years. In the stratified analysis using sex and age group there was considerable heterogeneity with adult onset type 1 diabetes appearing to track earlier and at a lower mean HbA 1c . Conclusions/interpretation In individuals with type 1 diabetes, glycaemic control measured by HbA 1c settles onto a long-term 'track' and this occurs on average by 5 years following diagnosis. Age at diagnosis modifies both the rate at which individuals settle into their track and the absolute HbA 1c tracking level for the next 10 years.

show abstract

“…In an early study with youth with T1D, more family stressors (e.g., financial, illness, school, interpersonal) in the previous year were associated with higher A1c [34]. More recent longitudinal studies found that any major life event in the past 3 months (e.g., death/illness in relative, suspension from school, divorce) was associated with accelerated increases in A1c [35, 36]. Among adults with T1D, experiencing more recent stressful life events was associated with worsening glycemic control [37, 38].…”

Section: Dimensions and Types Of Stressmentioning

confidence: 99%

Stress and A1c Among People with Diabetes Across the Lifespan

et al. 2016

View full text Add to dashboard Cite

Stress is known to negatively affect health and is a potentially serious barrier to diabetes-related health outcomes. This paper synthesizes what is known about stress and glycemic control among people with type 1 and type 2 diabetes across the lifespan. Chronic stress—especially in relation to living with diabetes—was most strongly associated with A1c, particularly among subgroups that face disproportionate stress, such as minority groups or adolescents/young adults. Mechanisms of the stress-A1c association include physiological, psychological, behavioral, and environmental links. Understanding the dimensions of stress as they relate to health in diabetes can be of significant clinical importance, and interventions targeting mechanisms that either exacerbate or buffer stress have reported modest improvements in A1c.

show abstract

HbA1c tracking and bio-psychosocial determinants of glycaemic control in children and adolescents with type 1 diabetes: retrospective cohort study and multilevel analysis

Abstract: Early HbA1c predicted future glycaemic control across childhood. Trajectories were further modified by biological factors, exposures to psychosocial adversity, and healthcare use.

Cited by 46 publications

References 40 publications

Glycemic control and sponsor rank of military dependents with type 1 diabetes mellitus

Glycemic control and sponsor rank of military dependents with type 1 diabetes mellitus

Clinically meaningful and lasting HbA1c improvement rarely occurs after 5 years of type 1 diabetes: an argument for early, targeted and aggressive intervention following diagnosis

Stress and A1c Among People with Diabetes Across the Lifespan

Contact Info

Product

Resources

About