Intensive diabetes management in adolescents with type 1 diabetes: the importance of intensive follow-up.
Minimal information exists on the education and follow-up required to successfully initiate intensive diabetes management (IDM) in adolescents with type 1 diabetes. We performed a retrospective analysis of HbA1c 3 and 15 months after initiation of IDM in two cohorts: (1) 17 patients who received individualised education in IDM and intensive early follow-up, and (2) 11 patients who participated in group education for initiation of IDM with standard follow-up. Entry HbA1c was higher in the individualised education patients (9.5 +/- 0.3% [mean +/- SE] versus 8.2 +/- 0.4%, p = 0.02). After 3 months of IDM, HbA1c improved in both cohorts reaching similar levels (individualised: 7.0 +/- 0.1%, p < 0.0001 vs entry; group: 7.3 +/- 0.2%, p = 0.05). During the following year, with routine follow-up for both cohorts, HbA1c levels rose approximately 1% as patients reverted to a multiple daily injection regimen. Irrespective of the educational approach, we believe maintenance of IDM and optimal HbA1c requires long-term intensive follow-up.
Lawson
M L
ML
Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada.
Frank
M R
MR
Fry
M K
MK
Perlman
K
K
Sochett
E B
EB
Daneman
D
D
D000293:Adolescent; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy*; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D010353:Patient Education as Topic; D012189:Retrospective Studies; D013997:Time Factors
D006442:Glycated Hemoglobin; D007328:Insulin