Quarterly visits with glycated hemoglobin monitoring: the sweet spot for glycemic control in youth with type 1 diabetes.
OBJECTIVE
To evaluate the association between the frequency of visits and glycated hemoglobin (GHb) measurements on glycemic control in youth with type 1 diabetes.


METHODS
A retrospective longitudinal cohort study of 1,449 youth with type 1 diabetes (mean age 11.4 years, 50% female, 74% Caucasian, 24% with Medicaid) followed at five pediatric endocrinology clinics from the years 2008-2011 was conducted. By hierarchical cluster analysis, three homogeneous groups of patients were generated: those with a relative increase in GHb (worsened [n = 237]), no change in GHb (stable [n = 842]), and a decrease in GHb (improved [n = 370]) over the study period. The number of visits and GHb measurements per year were compared among the three groups by multinomial logistic regression analysis using one visit or GHb test per year as a reference and controlling for patient demographic and baseline characteristics.


RESULTS
Patients with quarterly visits were least likely to have worsened glycemic control (odds ratio 0.33, P < 0.05) and were most likely to have improved glycemic control (3.48, P < 0.01). Patients with four GHb tests a year (0.53, P < 0.05) were least likely to have worsened glycemic control.


CONCLUSIONS
Quarterly visits and GHb testing are associated with glycemic control in youth with type 1 diabetes.
Corresponding author: Lloyd Neil Werk, lloyd.werk@nemours.org.
Thao-Ly
TL
Phan
Jobayer
J
Hossain
Stephen
S
Lawless
Lloyd Neil
LN
Werk
D000293:Adolescent; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001786:Blood Glucose / Q000032:analysis*; D002648:Child; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis* / Q000378:metabolism; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014481:United States
D001786:Blood Glucose; D006442:Glycated Hemoglobin