title: Does poor early metabolic control predict subsequent poor control in young children with type 1 diabetes: an exploratory study.
abstract: BACKGROUND
  We sought to determine whether poor metabolic control during the early stages of type 1 diabetes mellitus predicts control during subsequent years. We hypothesized that poor control in the first year after diagnosis would predict poor control in the following year, and that poor control in the second year after diagnosis would predict poor metabolic control in subsequent years.
  
  
  METHODS
  We conducted a retrospective review of a cohort of urban children treated for diabetes at our institution who were diagnosed between 1992 and 2005. We calculated odds ratios to determine whether control in year 1 or in year 2 predicted control in Years 3-6. Cox regression analyses were used to determine whether poor early control predicted progression to subsequent poor control.
  
  
  RESULTS
  Metabolic control in the first year after diagnosis was not a good predictor of future control. However, poor metabolic control in the second year after diagnosis was highly predictive of poor control in subsequent years and predicted faster progression to poor control.
  
  
  CONCLUSIONS
  The findings suggest that poor metabolic control in year 2 may be a predictor of subsequent poor metabolic control. Targeting prevention interventions to reduce non-adherence and to enhance metabolic control to families that show poor metabolic control in Year 2 may prove to be an optimum investment in terms of improved medical outcomes and enhanced quality of life.
authors: Department of Psychiatry Pediatrics, Mount Sinai School of Medicine, New York, New York, USA. claude.chemtob@nyumc.org
authors: Claude M
authors: CM
authors: Chemtob
authors: Carl J
authors: CJ
authors: Hochhauser
authors: Eyal
authors: E
authors: Shemesh
authors: James
authors: J
authors: Schmeidler
authors: Robert
authors: R
authors: Rapaport