title: Long-term glycemic control influences the onset of limited joint mobility in type 1 diabetes.
abstract: BACKGROUND
  Limited joint mobility (LJM) in childhood insulin-dependent (type 1) diabetes is associated with a substantially increased risk of microvascular complications. Cross-sectional studies have not demonstrated a relationship between LJM and metabolic control. This study was designed to determine whether glycemic control, as measured by glycohemoglobin (hgbA1C) levels from the onset of diabetes, is associated with the occurrence of LJM.
  
  
  METHODS
  Probands (n = 18) had hgbA1C values and recorded observation of joint function from soon after onset of their diabetes. Controls (n = 40) were matched to probands for gender and age at diagnosis and had follow-up beyond the age at which the proband was found to have LJM.
  
  
  RESULTS
  The odds ratio for occurrence of LJM for the mean hgbA1C from diabetes onset was 1.46, 95% confidence limits 1.07 to 2.00. Thus, for every unit increase in average hgbA1C, there was approximately a 46% increase in the risk of LJM. When hgbA1C was dichotomized, the OR for hgbA1C of more than 8% was 2.55, and the OR was 4.54 if the hgbA1C was greater than 12%. Age at diagnosis and duration of diabetes were not independent prognostic factors for LJM.
  
  
  CONCLUSIONS
  Glycemic control from onset of diabetes is strongly associated with occurrence of LJM.
authors.affiliation: Department of Pediatrics, University of Florida, Gainesville 32610, USA.
authors.forename: J H
authors.initials: JH
authors.lastname: Silverstein
authors.forename: G
authors.initials: G
authors.lastname: Gordon
authors.forename: B H
authors.initials: BH
authors.lastname: Pollock
authors.forename: A L
authors.initials: AL
authors.lastname: Rosenbloom
mesh_terms: D016022:Case-Control Studies; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007592:Joint Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors
chemical_list: D006442:Glycated Hemoglobin