Predictors of Loss to Follow-Up among Children with Type 2 Diabetes

Abstract

Background/Aims: Youth with type 2 diabetes (T2D) have poor compliance with medical care. This study aimed to determine which demographic and clinical factors differ between youth with T2D who receive care in a pediatric diabetes center versus youth lost to follow-up for >18 months. Methods: Data were analyzed from 496 subjects in the Pe­diatric Diabetes Consortium registry. Enrollment variables were selected a priori and analyzed with univariable and multivariable logistic regression models. Results: After a median of 1.3 years from enrollment, 55% of patients were lost to follow-up. The final model included age, race/ethnicity, parent education, and estimated distance to study site. The odds ratio (99% confidence interval) of loss to follow-up was 2.87 (1.34, 6.16) for those aged 15 to <18 years versus those aged 10 to <13 years and 6.57 (2.67, 16.15) for those aged ≥18 years versus those aged 10 to <13 years. Among patients living more than 50 miles from the clinic, the odds ra tio of loss to follow-up was 3.11 (1.14, 8.49) versus those living within 5 miles of the site. Conclusion: Older adolescents with T2D are more likely to be lost to follow-up, but other socioeconomic factors were not significant predictors of clinic follow-up.

Adolescent type 2 diabetes: Comparing the Pediatric Diabetes Consortium and Germany/Austria/Luxemburg Pediatric Diabetes Prospective registries

“…A disadvantaged background is disproportionately represented in both T2D pediatric cohorts as shown by the 85% of the PDC cohort self‐identified as Black or Hispanic out of a background US population estimate of 31.1% and in the DPV cohort with ~28% (Table S1) self‐reported as having a non‐EU country migrant background out of a ~11% migrant background in the DPV countries . Thus, youth with T2D are more likely to face greater challenges in managing diabetes than the T1D population . This needs to be taken into account when assessing resources required to provide optimal care for pediatric T2D patients.…”

“…26-28 Thus, youth with T2D are more likely to face greater challenges in managing diabetes than the T1D population. 18,24,[29][30][31] This needs to be taken into account when assessing resources required to provide optimal care for pediatric T2D patients.…”

<p>Compliance, adherence, concordance, empowerment, and self-management: five words to manifest a relational maladjustment in diabetes</p>

“… Adherence to the antidiabetic drug has been associated with the ethnic group. Shoemaker et al (2017) 88 USA Investigate the factors that lead teens with type 2 diabetes to not comply with the follow-up path. One of the factors that most affects the follow-up phase is the age: younger adolescents are more likely to follow the whole path.…”

“…When we talk about the factor of friendship we enter into subjectivity closely linked to the personality of the health professional. The studies on compliance in adolescence 64 – 70 , 88 highlighted that the crucial factor for achieving the best possible treatment depends mainly on the type of relationship that the patient is able to establish with health-care workers, family members and friends. It can be seen from other studies that the importance of the patient-health professional relationship seems to play a decisive role at any age.…”

Geospatial Analysis of Risk Factors Contributing to Loss to Follow-up in Cleft Lip/Palate Care

“…Additional stressors were postulated to predispose to these points of failure, including low socioeconomic status (SES), rural isolation, and distance from our cleft team. 3 – 5 …”