title: Insulin regimens, diabetes knowledge, quality of life, and HbA1c in children and adolescents with type 1 diabetes.
abstract: To further describe the changes in insulin therapy regimens and hemoglobin A1c (HbA1c) in children and adolescents with type 1 diabetes, and their associations with diabetes knowledge and quality of life.
  
  
  
  The study included 4293 children and adolescents (12.9 ± 2.6 yr, diabetes >1 yr) attending AJD (Aide aux Jeunes Diabétiques) summer camps between 2009 and 2014. The distribution of insulin regimens and associations between HbA1c, therapeutic regimens, diabetes knowledge (AJD questionnaire), and Quality of Life (Ingersoll et Marrero, Hvidoere Study Group short version) were assessed.
  
  
  
  The percentage of youth treated with insulin pumps increased up to about 45%, basal bolus stabilized around 40%, and other regimens decreased majorly. HbA1c was higher with premixed insulins only regimens (9.05 ± 2.43%), but there was no difference between pump (8.12 ± 1.09%), basal bolus (8.32 ± 1.33%) and two to three injections (8.18 ± 1.28%). Mean HbA1c decreased by 0.014% per year. The percentage of HbA1c <7.5% increased by 1.5% per year, and the percentages of HbA1c >9% or >10% decreased by 4 and 5.5%, changes being greater with the pump. HbA1c was weakly associated with diabetes knowledge, and strongly with general health perception and perception about diabetes.
  
  
  
  The percentage of children and adolescents with the highest risk of complications decreased markedly. The distribution of HbA1c better depicts the glycemic control in a population than the mean or the percentage of patients reaching the target (7.5%). HbA1c was more strongly associated with general health perception than with therapeutic regimens and diabetes knowledge.
authors.affiliation: Endocrinologie, Gynécologie et Diabétologie Pédiatrique, Hôpital Necker, Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Keller
authors.affiliation: Endocrinologie, Gynécologie et Diabétologie Pédiatrique, Hôpital Necker, Paris, France.
authors.forename: Radhouène
authors.initials: R
authors.lastname: Attia
authors.affiliation: Endocrinologie, Gynécologie et Diabétologie Pédiatrique, Hôpital Necker, Paris, France.|Université René Descartes, Sorbonne Paris Cité, Paris, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Beltrand
authors.affiliation: Laboratoire de Biostatistiques, Hôpital Necker, Paris, France.
authors.forename: Juliette
authors.initials: J
authors.lastname: Djadi-Prat
authors.affiliation: Laboratoire de Biochimie Générale, Hôpital Necker, Paris, France.
authors.forename: Thao
authors.initials: T
authors.lastname: Nguyen-Khoa
authors.affiliation: Université René Descartes, Sorbonne Paris Cité, Paris, France.|Laboratoire de Biochimie Générale, Hôpital Necker, Paris, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Jay
authors.affiliation: L'Aide aux Jeunes Diabétiques (AJD), Paris, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Cahané
authors.affiliation: L'Aide aux Jeunes Diabétiques (AJD), Paris, France.
authors.forename: Carine
authors.initials: C
authors.lastname: Choleau
authors.affiliation: Endocrinologie, Gynécologie et Diabétologie Pédiatrique, Hôpital Necker, Paris, France.|Université René Descartes, Sorbonne Paris Cité, Paris, France.|L'Aide aux Jeunes Diabétiques (AJD), Paris, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Robert
mesh_terms: D000293:Adolescent; D002648:Child; D017281:Cost of Illness; D048909:Diabetes Complications / Q000453:epidemiology / Q000517:prevention & control*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005602:France / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000032:analysis; D007722:Health Knowledge, Attitudes, Practice; D006306:Health 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 / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007332:Insulin Infusion Systems / Q000009:adverse effects; D008297:Male; D010353:Patient Education as Topic; D011788:Quality of Life; D012306:Risk
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: children and adolescents; diabetes knowledge; insulin therapy; quality of life; type 1 diabetes