title: Adherence to guidelines for youths with diabetes mellitus.
abstract: OBJECTIVE
  To describe demographic and clinical characteristics associated with self-reported receipt of tests and measurements recommended by the American Diabetes Association (ADA) for children and youths with diabetes.
  
  
  METHODS
  The study included 1514 SEARCH for Diabetes in Youth study participants who completed a survey about diabetes care received. Quality-of-care measures were based on ADA guidelines for eye examinations and glycohemoglobin (hemoglobin A1c [HbA1c]), lipid level, microalbuminuria, and blood pressure measurements, and a composite variable of these 5 indicators was created. Multivariate logistic regression models were used to assess the association of selected demographic and clinical characteristics with the reported receipt of all recommended tests and measurements according to age and diabetes type subgroups.
  
  
  RESULTS
  Overall, 95% of the participants reported having their blood pressure checked at all or most visits, 88% had lipid levels measured, 83% had kidney function tested, 68% underwent HbA1c testing, and 66% underwent an eye examination, in accordance with ADA recommendations. Participants aged 18 years or older, particularly those with type 2 diabetes, tended to have fewer tests of all kinds performed. Age and family income emerged as important correlates of overall quality of care in multivariate models; older age and lower income were associated with not meeting guidelines.
  
  
  CONCLUSIONS
  Although there was relatively good adherence to ADA-recommended guidelines for most indicators, efforts are needed to improve rates of HbA1c testing and eye examinations, particularly among older youths.
authors.affiliation: Pacific Health Research Institute, Honolulu, Hawaii, USA. beth.e.waitzfelder@kp.org
authors.forename: Beth
authors.initials: B
authors.lastname: Waitzfelder
authors.forename: Catherine
authors.initials: C
authors.lastname: Pihoker
authors.forename: Georgeanna
authors.initials: G
authors.lastname: Klingensmith
authors.forename: Doug
authors.initials: D
authors.lastname: Case
authors.forename: Andrea
authors.initials: A
authors.lastname: Anderson
authors.forename: Ronny A
authors.initials: RA
authors.lastname: Bell
authors.forename: Jean M
authors.initials: JM
authors.lastname: Lawrence
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Mayer-Davis
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Imperatore
authors.forename: Debra
authors.initials: D
authors.lastname: Standiford
authors.forename: Beatriz L
authors.initials: BL
authors.lastname: Rodriguez
authors.forename: Dana
authors.initials: D
authors.lastname: Dabelea
authors.forename: Michael
authors.initials: M
authors.lastname: Seid
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D014481:United States; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin