Characteristics of Adolescents With Type 1 Diabetes Who Exhibit Adverse Outcomes

Abstract

Purpose-The primary purpose of this study was to determine differences in key characteristics between adolescents with type 1 diabetes who experienced the adverse outcomes of poor glycemic control, hypoglycemic events, and hospitalizations due to their disease versus those who do not experience such events. A secondary purpose was to examine differences in outcomes for adolescents using insulin pumps versus daily insulin injections (≥ 2).Methods-Data from 108 adolescents were divided according to glycemic control (HbA 1c <8% vs. ≥8%), hypoglycemic reactions and hospitalizations in the past year (0 vs. ≥ 1 episode of each), and pump versus injection delivery of insulin. The following variables were compared within each grouping: body mass index (BMI) insulin dose, caloric intake, parental educational level, marital status, annual family income, race, and gender. HbA 1c was examined in relation to the number of hypoglycemic reactions and hospitalizations in the past year, as well as for any differences between those receiving insulin via pump therapy versus daily injections (≥ 2).

Racial and Ethnic Disparities in Adverse Drug Events: A Systematic Review of the Literature

“…Administrative claims data were the most common sources of primary ADE detection, used in 37.5 % (15/40) of studies [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Chart review was used as a primary ADE detection method in 35 % (14/40) of studies [8,[24][25][26][27][28][29][30][31][32][33][34][35][36], and survey or patient/ parent report was used in 27.5 % (11/40) of the studies [27,32,33,[37][38][39][40][41][42][43][44]. Direct documentation by research staff was used by three studies (7.5 %) [45][46][47].…”

“…Eight studies analyzed ADEs in the inpatient setting, eight in the outpatient setting, and two in the emergency department. The three studies that did not demonstrate a racial or ethnic disparity all analyzed patients in the outpatient setting, detected ADEs via survey or report, and had relatively small sample sizes of less than 600 participants [39,41,42].…”

Depleted parental psychological resources as mediators of the association of income with adherence and metabolic control.

“…Marital status was covaried to control for family status (i.e. single mother vs. intact family), which effects diabetes outcomes (Johns, Faulkner, & Quinn, 2008)…”

Good Cop, Bad Cop: Quality of Parental Involvement in Type 1 Diabetes Management in Youth

“…Recent studies have consistently linked single-parent households with poorer glycemic control in youth with T1D [55–57]. When examined longitudinally, youth living in single-parent and blended families exhibit significantly higher HbA1c levels than those living with biological parents [58], and glycemic control has been shown to deteriorate three times faster among adolescents from single-parent households than those from intact families [59].…”