Trajectories in glycated hemoglobin and body mass index in children and adolescents with diabetes using the common data model

Abstract

We evaluated trajectories of glycated hemoglobin (HbA1c) levels and body mass index z-scores (BMIz) for 5 years after diagnosis among Korean children and adolescents with type 1 diabetes (T1D) or type 2 diabetes (T2D) using the common data model. From the de-identified database of three hospitals, 889 patients < 15 years of age diagnosed with T1D or T2D (393 boys, 664 T1D patients) were enrolled. Diagnosis was defined as first exposure to antidiabetic drug at each center. Compared with T2D patients, T1D patients had lower BMIz at diagnosis (− 0.4 ± 1.2 vs. 1.5 ± 1.4, p < 0.001) and 3 months (− 0.1 ± 1.0 vs. 1.5 ± 1.5, p < 0.001), and higher HbA1c levels at diagnosis (10.0 ± 2.6% vs. 9.5 ± 2.7%, p < 0.01). After 3 months, HbA1c levels reached a nadir of 7.6% and 6.5% in T1D and T2D patients, respectively, followed by progressive increases; only 10.4% of T1D and 29.7% of T2D patients achieved the recommended HbA1c target (< 7.0%) at 60 months. T1D patients showed consistent increases in BMIz; T2D patients showed no significant change in BMIz during follow-up. Peri-pubertal girls with T1D had higher HbA1c and BMIz values. Achieving optimal glycemic control and preventing obesity should be emphasized in pediatric diabetes care.

Diagnostic and Therapeutic Strategies of Type 2 Diabetes Mellitus in Youth

“…Youth-onset T2DM is associated with poor glycemic control and early micro-and macrovascular complications [23,24]. Insulin resistance-related comorbidities, such as hypertension, dyslipidemia, and non-alcoholic fatty liver disease, may also be present at the time of T2DM diagnosis, which can accelerate the occurrence of micro-and macrovascular complications [25][26][27].…”

Diabetes mellitus and inequalities in the equipment and use of information technologies as a socioeconomic determinant of health in Spain

“…Diabetes mellitus (DM) is a serious chronic disease (CD) that is on the rise ( 21 – 23 ). Regardless of the patient's age, good care in the context of this CD is not easy, and has to be approached with the help of ongoing medical care and multifactorial interventions that do not simply focus on glycemic control ( 24 , 25 ). To achieve this, there is a need to reduce (as much as possible) the risk of developing complications associated with DM through good self-management ( 26 ).…”