title: Associations of demographic and behavioural factors with glycaemic control in young adults with type 1 diabetes mellitus.
abstract: BACKGROUND
  Despite recognised benefits of optimal glycaemic control in patients with type 1 diabetes mellitus (T1DM), good control is still difficult to achieve, particularly for adolescents and young adults. Recognition of factors that may assist early optimisation of glycaemic control is therefore important.
  
  
  OBJECTIVE
  We explored associations of demographic, social and behavioural factors with glycosylated haemoglobin (HbA1c) levels in participants with T1DM aged 18-25 years.
  
  
  METHODS
  A cross-sectional analysis was performed on young adults attending a dedicated multidisciplinary clinic at Fremantle Hospital, Western Australia from January to August 2014.
  
  
  RESULTS
  Data from 93 participants were analysed. Mean age was 21.4 ± 2.3 years, and 39.8% of the cohort were female. Longer duration of diabetes was associated with higher HbA1c (r = 0.25, P = 0.04). Men had lower HbA1c than women (8.2 ± 1.6 vs 9.2 ± 2.0%, P = 0.01). Increased frequency of clinic attendance was associated with lower HbA1c (r = -0.27, P = 0.02). Those engaged in work or study had better HbA1c compared with those who were not (8.9 ± 2.1 vs 10.5 ± 2.1%, P = 0.03). Socioeconomic disadvantage, risk-taking behaviour, insulin pump use and distance travelled to clinic were not associated with differences in HbA1c.
  
  
  CONCLUSIONS
  In young adults with T1DM, geographical separation, socioeconomic disadvantage and risk-taking behaviours did not influence glycaemic control. Longer duration of diabetes identifies young adults at higher risk of poor control, while attendance at a multidisciplinary clinic and engagement in work or study was associated with better glycaemic control. Additional studies are warranted to clarify the role of behavioural interventions to improve diabetes management in young adults.
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: J K
authors.initials: JK
authors.lastname: Osan
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: J D
authors.initials: JD
authors.lastname: Punch
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Watson
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.|Department of Endocrinology and Diabetes, Perth, Western Australia, Australia.
authors.forename: Y X
authors.initials: YX
authors.lastname: Chan
authors.affiliation: Diabetes Education Unit, Fiona Stanley and Fremantle Hospitals, Perth, Western Australia, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Barrie
authors.affiliation: Department of Endocrinology and Diabetes, Perth, Western Australia, Australia.
authors.forename: P G
authors.initials: PG
authors.lastname: Fegan
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.|Department of Endocrinology and Diabetes, Perth, Western Australia, Australia.
authors.forename: B B
authors.initials: BB
authors.lastname: Yeap
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000453:epidemiology / Q000523:psychology*; D004651:Employment / Q000639:trends; D005260:Female; D038321:Glycemic Index / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D012309:Risk-Taking; D014904:Western Australia / Q000453:epidemiology; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: behaviour; glycosylated haemoglobin A; psychosocial factor; type 1 diabetes; young adult