title: Children and adolescents with type 1 diabetes and high HbA1c -- a neurodevelopmental perspective.
abstract: OBJECTIVE
  To examine the association between neurodevelopmental problems and high HbA1c among paediatric patients with type 1 diabetes.
  
  
  METHODS
  A population-based study was performed among patients with type 1 diabetes (5-16 years) in two Swedish counties (n = 233). The Five to Fifteen (FTF) questionnaire targeted neurodevelopmental qualities. Scores above the 90th percentile in the various domains are considered as definitive problems and scores above the 75th percentile as mild. FTF scores were compared with regard to HbA1c ≤73 mmol/mol and >73 mmol/mol (8.0%).
  
  
  RESULTS
  The response rate was 190 (82%). Neurodevelopmental problems were not overrepresented among patients in general. Memory and learning problems were associated with HbA1c >73 mmol/mol (p = 0.01). This correlation was especially seen in adolescents (12-16 years) where mild executive problems (adjOR 3.1), definite memory problems (adjOR 5.0) and definite learning problems (adjOR 5.0) were associated with HbA1c >73 mmol/mol after adjustment for gender, diabetes duration and age of onset.
  
  
  CONCLUSIONS
  Our findings that high HbA1c is more common in adolescent diabetes patients with neurodevelopmental problems generate the hypothesis that these problems might precede poor metabolic control. If so, early detection of neurodevelopmental problems would allow individually tailored treatment that may improve metabolic control and prevent complications.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Sweden. charlotte.nylander@kbh.uu.se
authors.forename: Charlotte
authors.initials: C
authors.lastname: Nylander
authors.forename: Henri
authors.initials: H
authors.lastname: Toivonen
authors.forename: Salmir
authors.initials: S
authors.lastname: Nasic
authors.forename: Ulf
authors.initials: U
authors.lastname: Söderström
authors.forename: Ylva
authors.initials: Y
authors.lastname: Tindberg
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Fernell
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D048909:Diabetes Complications / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism*; D042241:Early Diagnosis; D056344:Executive Function / Q000502:physiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007859:Learning Disabilities / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D019957:Motor Skills Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D011159:Population Surveillance; D011795:Surveys and Questionnaires; D013548:Sweden
chemical_list: D006442:Glycated Hemoglobin
keywords: Child and adolescent; HbA1c; Neurodevelopmental problems; Type 1 Diabetes Mellitus; ‘Five to Fifteen’ questionnaire