Location: Children's Nutrition Research CenterTitle: Pediatric diabetes consortium type 1 diabetes new onset (NeOn) study: Factors associated with HbA1c levels one year after diagnosis
|Redondo, Maria - Texas Children'S Hospital|
|Connor, Crystal - Jaeb Center For Health Research|
|Ruedy, Katrina - Jaeb Center For Health Research|
|Beck, Roy - Jaeb Center For Health Research|
|Kollman, Craig - Jaeb Center For Health Research|
|Wood, Jamie - Children'S Hospital Los Angeles|
|Buckingham, Bruce - Stanford University|
|Klingensmith, Georgeanna - University Of Colorado|
|Silverstein, Janet - University Of Florida|
|Tamborlane, William - Yale University|
|Haymond, Morey - Children'S Nutrition Research Center (CNRC)|
Submitted to: Pediatric Diabetes
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/1/2014
Publication Date: 6/1/2014
Citation: Redondo, M.J., Connor, C.G., Ruedy, K.J., Beck, R.W., Kollman, C., Wood, J.R., Buckingham, B., Klingensmith, G.J., Silverstein, J., Tamborlane, W.V., Pediatric Diabetes Consortium 2014. Pediatric diabetes consortium type 1 diabetes new onset (NeOn) study: Factors associated with HbA1c levels one year after diagnosis. Pediatric Diabetes. 15(4):294-302.
Interpretive Summary: This study was undertaken to determine the factors that affect blood sugar control over the first year of diabetes. Determining these factors will permit us to help children and their families to achieve better blood sugar control, which relates to the complications of diabetes and to normal metabolism and nutrition. Data from 857 participants who were not involved with any other theraputic trials were analyzed. Gender, age, pubertal development, body mass index (BMI), diabetic ketoacidosis (DKA) at onset, number of positive autoantibodies or HbA1c at onset, or number of visits to diabetes physician during the first year were not important factors. The medical center where the children were receiving care, being of non-Hispanic White race, having private health insurance, living with both parents, subjects measuring their blood sugar more often and lower insulin requirements were all associated with better blood sugar control. Clearly socioeconomic factors are of primary importance in achieving good blood sugar control over the first year of diabetes.
Technical Abstract: To identify determinants of hemoglobin A1c (HbA1c) levels 1 yr after the diagnosis of type 1 diabetes (T1D) in participants in the Pediatric Diabetes Consortium (PDC) T1D New Onset (NeOn) Study. Diabetes-specific as well as socioeconomic factors during the first year following diagnosis were analyzed in 857 participants (mean age 9.1 yrs, 51% female, 66% non-Hispanic White) not participating in an intervention study who had an HbA1c value at 12 months. Mean +/- SD HbA1c at 1 yr was 62 +/- 16 mmol/mol (7.8% +/- 1.5). In univariate and multivariate analyses, clinical center, non-Hispanic White race, private health insurance, living with both parents, higher frequency of self-monitoring of blood glucose (SMBG), and lower insulin requirements were associated with lower HbA1c concentrations at 1 yr (p < 0.01). No association was found with gender, age, Tanner stage, body mass index (BMI), diabetic ketoacidosis (DKA) at onset, number of positive autoantibodies or HbA1c at onset, or number of visits to diabetes physician during the first year. White race, higher socioeconomic status, two-parent household, more frequent SMBG, and low insulin requirements are associated with lower HbA1c concentration 1 yr after the onset of T1D in children.