Format

Send to

Choose Destination
Pediatr Diabetes. 2017 May;18(3):241-248. doi: 10.1111/pedi.12378. Epub 2016 Mar 16.

The role of socio-economic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: an Italian multicentre survey.

Author information

1
Centre of Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, Italy.
2
Centre of Paediatric Diabetology, San Raffaele Hospital, Milan, Italy.
3
Centre of Paediatric Diabetology, University of Chieti, Chieti, Italy.
4
Division of Paediatric Diabetes, Women's and Children's Health, AOU Ancona, Salesi Hospital, Ancona, Italy.
5
Unit of Paediatric Diabetes, Brotzu Hospital, Cagliari, Italy.
6
Centre of Paediatric Diabetology, Second University of Naples, Naples, Italy.
7
Department of Paediatrics, University of Messina, Messina, Italy.
8
Centre of Paediatric Diabetology, University Federico II, Naples, Italy.
9
Department of Physiopathology and transplantation, University of Milan, Milan, Italy.
10
Department of Pediatrics, University of Turin, Turin, Italy.
11
Centre of Paediatric Diabetology, University of Verona, Verona, Italy.
12
Department of Paediatrics, Insubria University, Varese, Italy.
13
Centre of Paediatric Diabetology, Sacco Hospital, Milan, Italy.
14
Endocrinology and diabetes, Bambino Gesù Hospital, Rome, Italy.
15
Centre of Paediatric Diabetology, University La Sapienza, Rome, Italy.
16
Pediatrics, AOU Meyer Children's Hospital, Florence, Italy.
17
General Direction of Health Care Planning, Health Ministry, Rome, Italy.

Abstract

OBJECTIVE:

To identify the role of the family's socio-economic and clinical characteristics on metabolic control in children and adolescents with type 1 diabetes.

METHODS:

In this cross-sectional, multicentre study, 768 subjects with type 1 diabetes under 18 years of age were consecutively recruited from January 2008 to February 2009. Target condition was considered for HbA1c values <7.5% (<58 mmol/mol). A multiple correspondence analysis (MCA) was performed to analyze the association between the socio-economic and clinical characteristics of the participants. A logistic regression analysis was performed to identify factors associated with the subjects metabolic control. In both analyses, the family's socio-economic status was represented, measured by the Hollingshead Four-Factor Index of Social Status (SES) or by parental years of education.

RESULTS:

A total of 28.1% of subjects reached target HbA1c values. The MCA identified a strong association between at-target condition and several factors: high levels of SES or high levels of parental education, the use of the carbohydrate counting system, the use of insulin pumps, the use of the insulin delivery system over a short period of time, a normal body mass index. The logistic regression analysis showed that SES and the mother's years of education were significantly associated with the target condition [odds ratio (OR): 1.01, 95% confidence interval (CI): 1.01-1.03, p = 0.029; OR: 1.05, 95% CI: 1.01-1.10, p = 0.027, respectively).

CONCLUSIONS:

Personal, clinical, and family characteristics were found to be associated with HbA1c target. Their identification can be crucial in addressing strategies to optimize metabolic control and improve diabetes management.

KEYWORDS:

Hb A1c; child; quality of life; socioeconomic status; type 1 diabetes mellitus

PMID:
26990605
DOI:
10.1111/pedi.12378
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center