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Pediatr Diabetes. 2018 May;19(3):486-492. doi: 10.1111/pedi.12550. Epub 2017 Jun 30.

Comparable glycemic outcomes for pediatric type 1 diabetes patients in metropolitan and non-metropolitan regions of Western Australia: A population-based study.

Author information

1
Department of Endocrinology and Diabetes, Princess Margaret Hospital, Perth, Australia.
2
Telethon Kids Institute, University of Western Australia, Perth, Australia.
3
School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.

Abstract

BACKGROUND:

Pediatric patients diagnosed with type 1 diabetes (T1D) in Western Australia (WA) are managed by a single, specialist multidisciplinary diabetes service based at a central tertiary hospital in the capital city, Perth, which provides outreach care in regional centers.

OBJECTIVE:

To investigate the hypothesis that outcomes for a contemporary, population-based pediatric T1D cohort, managed by a single tertiary service are similar for metropolitan and non-metropolitan patients using this model of care. To confirm that the cohort is indeed population based, a secondary aim of the study was to determine the case ascertainment of the Western Australian Children's Diabetes Database (WACDD).

METHODS:

Data for all T1D patients aged <18 years, who attended the diabetes clinics (metropolitan and non-metropolitan), at least once in 2014, were extracted from the WACDD and outcomes including HbA1c and severe hypoglycemia (SH) rates analyzed.

RESULTS:

In 2014, a total of 1017 patients (492 females, 525 males) attended the diabetes clinics (54% metropolitan and 46% non-metropolitan). After adjusting for age, sex, diabetes duration, and insulin regimen, region of clinic was not a significant predictor of mean HbA1c or SH rate. The case ascertainment of the WACDD was estimated to be 99.9% complete for children diagnosed with T1D aged <15 years between 2002 and 2012.

CONCLUSIONS:

This study reports similar glycemic outcomes for patients attending diabetes clinics in metropolitan and non-metropolitan areas of WA, suggesting that a model of care provided as outreach from a specialized diabetes service is effective in achieving equitable glycemic outcomes.

KEYWORDS:

centralized service; children; glycemic outcome; region; type 1 diabetes

PMID:
28664634
DOI:
10.1111/pedi.12550
[Indexed for MEDLINE]

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