Predictors of glycemic control and short-term adverse outcomes in youth with type 1 diabetes

J Pediatr. 2001 Aug;139(2):197-203. doi: 10.1067/mpd.2001.116283.

Abstract

Objectives: To examine predictors of glycemic control and to assess how glycemic control affects the incidence of short-term adverse outcomes in a pediatric population with type 1 diabetes.

Study design: Three hundred youth, aged 7 to 16 years, with type 1 diabetes who were receiving diabetes specialty care were followed up prospectively for 1 year. Treatment plans and frequency of adverse outcomes were ascertained by questionnaires and medical record review. Incidence rates of adverse outcomes were compared among 3 strata of the population, representing tertiles of baseline glycosylated hemoglobin (HbA1c).

Results: Blood glucose monitoring frequency was the sole modifiable predictor of HbA1c (P <.0001). Overall incidence rate of hospitalization was 13 per 100 person-years, more than 3 times the rate in the general pediatric population and significantly higher in the upper HbA1c tertile compared with the other strata (P =.001). Rate of emergency department use was 29 per 100 person-years and did not differ significantly among tertiles. Incidence of severe hypoglycemia was 62 per 100 person-years and notably high even in those with poorest glycemic control.

Conclusion: Despite improvements in diabetes care, the incidence of short-term adverse events in children with type 1 diabetes remains high, particularly in those with poorest glycemic control.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Blood Glucose Self-Monitoring*
  • Child
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetic Ketoacidosis / etiology
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Glycated Hemoglobin A / drug effects*
  • Hospitalization / statistics & numerical data
  • Humans
  • Hypoglycemia / etiology
  • Insulin / adverse effects*
  • Insulin / therapeutic use
  • Male
  • Predictive Value of Tests
  • Prospective Studies
  • Surveys and Questionnaires

Substances

  • Glycated Hemoglobin A
  • Insulin