title: The role of socio-economic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: an Italian multicentre survey.
abstract: To identify the role of the family's socio-economic and clinical characteristics on metabolic control in children and adolescents with type 1 diabetes.
  
  
  
  In this cross-sectional, multicentre study, 768 subjects with type 1 diabetes under 18 years of age were consecutively recruited from January 2008 to February 2009. Target condition was considered for HbA1cvalues <7.5% (<58 mmol/mol). A multiple correspondence analysis (MCA) was performed to analyze the association between the socio-economic and clinical characteristics of the participants. A logistic regression analysis was performed to identify factors associated with the subjects metabolic control. In both analyses, the family's socio-economic status was represented, measured by the Hollingshead Four-Factor Index of Social Status (SES) or by parental years of education.
  
  
  
  A total of 28.1% of subjects reached target HbA1c values. The MCA identified a strong association between at-target condition and several factors: high levels of SES or high levels of parental education, the use of the carbohydrate counting system, the use of insulin pumps, the use of the insulin delivery system over a short period of time, a normal body mass index. The logistic regression analysis showed that SES and the mother's years of education were significantly associated with the target condition [odds ratio (OR): 1.01, 95% confidence interval (CI): 1.01-1.03, p = 0.029; OR: 1.05, 95% CI: 1.01-1.10, p = 0.027, respectively).
  
  
  
  Personal, clinical, and family characteristics were found to be associated with HbA1ctarget. Their identification can be crucial in addressing strategies to optimize metabolic control and improve diabetes management.
authors.affiliation: Centre of Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Rosaria
authors.identifier: 0000-0002-6943-0602
authors.initials: R
authors.lastname: Gesuita
authors.affiliation: Centre of Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Edlira
authors.initials: E
authors.lastname: Skrami
authors.affiliation: Centre of Paediatric Diabetology, San Raffaele Hospital, Milan, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bonfanti
authors.affiliation: Centre of Paediatric Diabetology, University of Chieti, Chieti, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Cipriano
authors.affiliation: Division of Paediatric Diabetes, Women's and Children's Health, AOU Ancona, Salesi Hospital, Ancona, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Ferrito
authors.affiliation: Unit of Paediatric Diabetes, Brotzu Hospital, Cagliari, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Frongia
authors.affiliation: Centre of Paediatric Diabetology, Second University of Naples, Naples, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Iafusco
authors.affiliation: Division of Paediatric Diabetes, Women's and Children's Health, AOU Ancona, Salesi Hospital, Ancona, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Iannilli
authors.affiliation: Department of Paediatrics, University of Messina, Messina, Italy.
authors.forename: Fortunato
authors.initials: F
authors.lastname: Lombardo
authors.affiliation: Centre of Paediatric Diabetology, University Federico II, Naples, Italy.
authors.forename: Enza
authors.initials: E
authors.lastname: Mozzillo
authors.affiliation: Department of Physiopathology and transplantation, University of Milan, Milan, Italy.
authors.forename: Renata
authors.initials: R
authors.lastname: Paleari
authors.affiliation: Department of Pediatrics, University of Turin, Turin, Italy.
authors.forename: Ivana
authors.initials: I
authors.lastname: Rabbone
authors.affiliation: Centre of Paediatric Diabetology, University of Verona, Verona, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Sabbion
authors.affiliation: Department of Paediatrics, Insubria University, Varese, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Salvatoni
authors.affiliation: Centre of Paediatric Diabetology, Sacco Hospital, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Scaramuzza
authors.affiliation: Endocrinology and diabetes, Bambino Gesù Hospital, Rome, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Schiaffini
authors.affiliation: Centre of Paediatric Diabetology, University La Sapienza, Rome, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Sulli
authors.affiliation: Pediatrics, AOU Meyer Children's Hospital, Florence, Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Toni
authors.affiliation: Centre of Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, Italy.|General Direction of Health Care Planning, Health Ministry, Rome, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Carle
authors.affiliation: Division of Paediatric Diabetes, Women's and Children's Health, AOU Ancona, Salesi Hospital, Ancona, Italy.
authors.forename: Valentino
authors.initials: V
authors.lastname: Cherubini
mesh_terms: D000293:Adolescent; D002648:Child; D003131:Combined Modality Therapy / Q000191:economics; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy* / Q000191:economics; D003927:Diet, Diabetic / Q000191:economics; D004522:Educational Status; D006442:Glycated Hemoglobin / Q000032:analysis; D019538:Health Care Surveys; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D007332:Insulin Infusion Systems / Q000009:adverse effects / Q000191:economics; D007558:Italy; D009035:Mothers / Q000193:education; D011788:Quality of Life; D012959:Socioeconomic Factors
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: Hb A1c; child; quality of life; socioeconomic status; type 1 diabetes mellitus