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J Pediatr. 2001 Aug;139(2):197-203.

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

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1
Pediatric and Adolescent Unit and the Section of Genetics and Epidemiology, Joslin Diabetes Center, Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA

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.

PMID:
11487743
DOI:
10.1067/mpd.2001.116283
[Indexed for MEDLINE]

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