Quarterly visits with glycated hemoglobin monitoring: the sweet spot for glycemic control in youth with type 1 diabetes

TitleQuarterly visits with glycated hemoglobin monitoring: the sweet spot for glycemic control in youth with type 1 diabetes
Publication TypeJournal Article
Year of Publication2014
AuthorsPhan, T. - L., Hossain J., Lawless S., & Werk L. N.
JournalDiabetes Care
Volume37
Issue2
Pagination341-5
Date Published2014 Feb
ISSN1935-5548
KeywordsAdolescent; Ambulatory Care; Blood Glucose; Child; Cohort Studies; Diabetes Mellitus, Type 1; Female; Hemoglobin A, Glycosylated; Humans; Male; Retrospective Studies; United States
Abstract

OBJECTIVE: To evaluate the association between the frequency of visits and glycated hemoglobin (GHb) measurements on glycemic control in youth with type 1 diabetes.
RESEARCH DESIGN AND METHODS: A retrospective longitudinal cohort study of 1,449 youth with type 1 diabetes (mean age 11.4 years, 50% female, 74% Caucasian, 24% with Medicaid) followed at five pediatric endocrinology clinics from the years 2008-2011 was conducted. By hierarchical cluster analysis, three homogeneous groups of patients were generated: those with a relative increase in GHb (worsened [n = 237]), no change in GHb (stable [n = 842]), and a decrease in GHb (improved [n = 370]) over the study period. The number of visits and GHb measurements per year were compared among the three groups by multinomial logistic regression analysis using one visit or GHb test per year as a reference and controlling for patient demographic and baseline characteristics.
RESULTS: Patients with quarterly visits were least likely to have worsened glycemic control (odds ratio 0.33, P < 0.05) and were most likely to have improved glycemic control (3.48, P < 0.01). Patients with four GHb tests a year (0.53, P < 0.05) were least likely to have worsened glycemic control.
CONCLUSIONS: Quarterly visits and GHb testing are associated with glycemic control in youth with type 1 diabetes.




DOI10.2337/dc13-0980
Alternate JournalDiabetes Care
Refereed DesignationRefereed