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

Bat Sheva Levine, Barbara J. Anderson, Deborah A. Butler, Jeanne E. Antisdel, Julienne Brackett, L. M B Laffel

Research output: Contribution to journalArticlepeer-review

234 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)197-203
Number of pages7
JournalJournal of Pediatrics
Volume139
Issue number2
DOIs
StatePublished - 2001

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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