Predictors of glycemic control in children and adolescents with type 1 diabetes at 12 months after diagnosis

Abstract

Identifying risk factors for suboptimal glycemic control during the first year after diagnosis with type 1 diabetes (T1D) may provide early appropriate and individualized management. Our aim was to study possible predictors of early glycemic control during the first year after diagnosis with T1D in children and adolescents in Jordan. This is a retrospective study conducted through a review of medical records at Jordan University Hospital and the National Centre for Diabetes, Endocrinology and Genetics. Children and adolescents diagnosed with T1D at age younger than 16 years and with diabetes duration of at least 2 years were included. Demographic, clinical and socioeconomic factors were collected, in addition to glycosylated hemoglobin (HbA1c) values during the first year after diagnosis. Average age at diagnosis of the 337 patients who were enrolled in the study was 7.7 ± 3.8 years. HbA1c at diagnosis was 10.9 ± 1.9% (95.64 ± 20.76 mmol/mol). Factors such as the involvement of children's mothers in deciding insulin doses, higher mother's educational level and higher family monthly income were associated with better early glycemic control. HbA1c at 6 months after diagnosis, parental marital status and compliance to counting carbohydrates were significant predictors of glycemic control at 12 months after diagnosis. Many clinical and socioeconomic factors were associated with early glycemic control at 12 months after diagnosis. Modifiable risk factors must be addressed as early as possible to decrease future complications. Children with nonmodifiable risk factors should be identified early for closer observation and providing individualized diabetes care plan.

Sociodemographic factors affecting glycaemic control in Finnish paediatric patients with type 1 diabetes

“…Our findings are in accordance with previous studies. Similar results have also been reported both in developed countries, 15 , 16 and in developing countries, 17 , 18 , 19 , 20 Highly educated parents may be keener on controlling the child's diabetes management and may be more concentrated to help their child with daily diabetes care. Another explanation could be that lower level of parental education may associate with weaker diabetes knowledge among the parents.…”

Effect on Glycemic Control of an Early Intensive Dietary Structured Education Program for Newly Diagnosed Children with Type 1 Diabetes in Jordan

“…Te percentage of PwD whose insulin doses were decided by themselves or their mothers was signifcantly higher in the SEP group. Tis may be because mothers are usually the main caregivers, in charge of executing the diabetes care plan and in direct contact with the diabetes clinical team [40,41], especially when engaged in the SEP. Te percentage of PwD with frst-degree relatives with T1D at the time of diagnosis was more in the pre-SEP group. Although it might be expected that PwD with frst-degree relatives with T1D would have more experience in daily diabetes care, this did not seem a signifcant factor in achieving better glycemic control compared to acquiring skills through the SEP.…”

Narrowing the Divide: The Role of Telehealth in Type 1 Diabetes Care for Marginalized Communities

“…28 For adolescents and children with T1D, family dynamics are also a strong determinant of glycemic control. [74][75][76][77][78] Behavioral Family Systems Therapy (BFST), 79 a familytargeted skills building intervention designed to address barriers to diabetes management, has been successfully modified to be delivered via telehealth. When compared with office-based delivery of BFST, BFST delivered via telehealth was equivalent and demonstrated success in improving HbA1c, improving diabetes self-management, and reducing depressive symptoms in youth as well as parent-child conflict.…”