Predictors of metabolic control at one year in a population of pediatric patients with type 2 diabetes mellitus: a retrospective study.
OBJECTIVE
The rising prevalence of pediatric type 2 diabetes mellitus (DM2) and non-adherence to diabetes regimens pose challenges to obtaining optimal control. This study evaluated factors that may impact glycemic control (HbA1c): age, Tanner stage, body mass index (BMI), total daily insulin (TDD), metformin dose (MET), activity level, frequency of clinic visits and adherence.


METHODS
One-year data from 72 patients (ages 8.6-17.8 years) were collected retrospectively. From that sample, 57 patients who continued to attend clinic for the entire year were assessed and divided into optimal and suboptimal HbA1c control groups.


RESULTS
All factors measured were similar in the two groups, except for lower initial and 1.0-year HbA1c, TDD, and rates of missing MET and insulin in the optimal HbA1c control group.


CONCLUSIONS
Initial glycemic status and adherence rate predicted metabolic control at one year. Early identification of DM2 may improve metabolic outcome, which may improve medical regimen adherence.
Alemzadeh
Ramin
R
Department of Pediatrics, Section of Pediatric Endocrinology & Metabolism, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA. ralemzad@mcw.edu
Ellis
James
J
Calhoun
Mariaelena
M
Kichler
Jessica
J
D000293:Adolescent; D000375:Aging / Q000502:physiology; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism; D004493:Education; D005190:Family; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008687:Metformin / Q000008:administration & dosage / Q000627:therapeutic use; D009043:Motor Activity / Q000502:physiology; D009752:Nutritional Status; D010349:Patient Compliance; D011627:Puberty / Q000502:physiology; D012189:Retrospective Studies
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin