Journal article
Hemoglobin A1c (HbA1c) changes over time among adolescent and young adult participants in the T1D exchange clinic registry
Pediatric diabetes, Vol.17(5), pp.327-336
08/2016
DOI: 10.1111/pedi.12295
PMID: 26153338
Abstract
Objective: Hemoglobin A1c (HbA1c) levels among individuals with type 1 diabetes (T1D) influence the longitudinal risk for diabetes-related complications. Few studies have examined HbA1c trends across time in children, adolescents, and young adults with T1D. This study examines changes in glycemic control across the specific transition periods of pre-adolescence-to-adolescence and adolescence-to-young adulthood, and the demographic and clinical factors associated with these changes.
Research design and methods: Available HbA1c lab results for up to 10 yr were collected from medical records at 67 T1D Exchange clinics. Two retrospective cohorts were evaluated: the pre-adolescent-to-adolescent cohort consisting of 85 016 HbA1c measurements from 6574 participants collected when the participants were 8-18 yr old and the adolescent-to-young adult cohort, 2200 participants who were 16-26 yr old at the time of 17 279 HbA1c measurements.
Results: HbA1c in the 8-18 cohort increased over time after age 10 yr until ages 16-17; followed by a plateau. HbA1c levels in the 16-26 cohort remained steady from 16-18, and then gradually declined. For both cohorts, race/ethnicity, income, health insurance, and pump use were all significant in explaining individual variations in age-centered HbA1c (p < 0.001). For the 8-18 cohort, insulin pump use, age of onset, and health insurance were significant in predicting individual HbA1c trajectory.
Conclusions: Glycemic control among patients 8-18 yr old worsens over time, through age 16. Elevated HbA1c levels observed in 18 yr-olds begin a steady improvement into early adulthood. Focused interventions to prevent deterioration in glucose control in pre-adolescence, adolescence, and early adulthood are needed.
Keywords: HbA1c; diabetes mellitus type 1; insulin; pediatric transition to adult care; retrospective studies.
Details
- Title: Subtitle
- Hemoglobin A1c (HbA1c) changes over time among adolescent and young adult participants in the T1D exchange clinic registry
- Creators
- Mark A Clements - Pediatrics (Endocrinology), Children's Mercy Hospitals and Clinics, MO, 64018, Kansas City, USANicole C Foster - Jaeb Center for Health Research, T1D Exchange, FL, 33647, Tampa, USADavid M Maahs - Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, CO, 80045, Aurora, USADesmond A Schatz - University of Florida College of Medicine, Division of Endocrinology, FL, 32610, Gainesville, USABeth A Olson - Park Nicollet International Diabetes Center, MN, 55416, Minneapolis, USAEva Tsalikian - University of Iowa Children's Hospital, Department of Pediatrics, IA, 52242, Iowa City, USAJoyce M Lee - Pediatric Endocrinology, University of Michigan, Department of Pediatrics and Communicable Diseases, MI, 48109, Ann Arbor, USAChristine M Burt-Solorzano - University of Virginia Health System, Department of Pediatrics, VA, Charlottesville, 22908USAWilliam V Tamborlane - Yale University School of Medicine, CT, 06520, New Haven, USAVincent Chen - Jaeb Center for Health Research, T1D Exchange, FL, 33647, Tampa, USAKellee M Miller - Jaeb Center for Health Research, T1D Exchange, FL, 33647, Tampa, USARoy W Beck - Jaeb Center for Health Research, T1D Exchange, FL, 33647, Tampa, USAT1D Exchange Clinic Network
- Resource Type
- Journal article
- Publication Details
- Pediatric diabetes, Vol.17(5), pp.327-336
- DOI
- 10.1111/pedi.12295
- PMID
- 26153338
- NLM abbreviation
- Pediatr Diabetes
- ISSN
- 1399-543X
- eISSN
- 1399-5448
- Publisher
- John Wiley & Sons A/S
- Number of pages
- 10
- Grant note
- DOI: 10.13039/100007028, name: Leona M. and Harry B. Helmsley Charitable Trust
- Language
- English
- Date published
- 08/2016
- Academic Unit
- Stead Family Department of Pediatrics; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9984093505602771
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