Insulin regimens, diabetes knowledge, quality of life, and HbA1c in children and adolescents with type 1 diabetes

Keller, M.; Attia, R.; Beltrand, Jacques; Djadi-Prat, Juliette; Nguyen–Khoa, Thao; Jay, J.P.; Cahané, M.; Choleau, Carine; Robert, Jean‐Jacques

doi:10.1111/pedi.12397

Cited by 18 publications

(8 citation statements)

References 33 publications

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“…In addition, Keller et al concluded that general health perception was more strongly associated with improvement in glycemic control than insulin regimens and diabetes knowledge. In contrast to these reports, our data suggest that improved glycemic control was associated with progress and development of treatment, especially basal‐bolus treatment with insulin analogs . We consider that the observed improvement in glycemic control in this study was also associated with general health perception resulting from safety treatment with rapid‐ and long‐acting insulin analogs without hypoglycemia, particularly in adolescents.…”

Section: Discussioncontrasting

confidence: 97%

Improvement in glycemic control through changes in insulin regimens: findings from a Japanese cohort of children and adolescents with type 1 diabetes

et al. 2016

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Section: Discussioncontrasting

confidence: 97%

Improvement in glycemic control through changes in insulin regimens: findings from a Japanese cohort of children and adolescents with type 1 diabetes

et al. 2016

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“…A previous audit of diabetes care provision and glycaemic control in Northern Ireland found that mean HbA1c was 8.8% (73 mmol/mol) in 2002 with only 20% of children achieving target levels of less than 7.5% (58 mmol/mol). It would be expected that if intensive diabetes treatment regimens, and the uptake of insulin pumps in conjunction with education programmes were to increase in the United Kingdom in line with other countries, there would be improvements in HbA1c and reductions in subsequent diabetes‐related complications and mortality.…”

Section: Discussionmentioning

confidence: 99%

Mortality in type 1 diabetes diagnosed in childhood in Northern Ireland during 1989-2012: A population-based cohort study

et al. 2017

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Objective: To investigate long-term mortality rates and causes of death in individuals diagnosed with type 1 diabetes before the age of 15 years during the period 1989-2012 or known to paediatric diabetes teams in 1989, in Northern Ireland.Methods: A cohort of 3129 patients from the Northern Ireland Childhood Diabetes Register was linked to death registrations and underlying causes, coded according to ICD-9 or ICD-10.Standardized mortality ratios (SMRs) were calculated as the ratio of observed to expected deaths by sex, attained age, time since diagnosis, calendar period, and cause of death.Results: Subjects were followed to December 31, 2012 giving 39 764 person-years of follow-up (median 12.1 years). In total, 59 subjects had died (1.5 per 1000 person-years) compared with 19.9 deaths expected, an SMR of 296 (95% confidence interval (CI) 229-382).Women had a significantly higher excess risk of mortality than men with SMRs of 535 (95% CI 361-764) and 203 (95% CI 136-291), respectively. Over half of the deaths (56%) were judged to be related or possibly related to diabetes with most of these due to acute (n = 24) or late (n = 6) complications.Conclusions: Subjects with type 1 diabetes diagnosed less than 15 years of age had 3 times the mortality risk of the general population. Over half of the deaths were related to acute or chronic complications of diabetes. K E Y W O R D Smortality, standardized mortality ratio, type 1 diabetes

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“…In adolescents, self-efficacy is associated with better HbA1c and adherence to diabetes care 62–64. (7) Diabetes knowledge assessed using L'Aide aux Jeunes Diabétiques Diabetes Knowledge and Skills questionnaire (at 0, 12, 24 months) 65–67. (8) Transition readiness measured using the Am I ON TRAC?…”

Section: Methods and Analysismentioning

confidence: 99%

Group education for adolescents with type 1 diabetes during transition from paediatric to adult care: study protocol for a multisite, randomised controlled, superiority trial (GET-IT-T1D)

et al. 2019

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IntroductionTransition from paediatric to adult care is challenging for adolescents and emerging adults (ages 18 to 30 years) with type 1 diabetes (T1D). This transition is characterised by a deterioration in glycaemic control (haemoglobin A1c (HbA1c)), decreased clinical attendance, poor self-management and increased acute T1D-related complications. However, evidence to guide delivery of transition care is lacking. Given the effectiveness of group education in adult diabetes glycaemic control and improvements in qualitative measures in paediatric diabetes, group education is a potentially feasible and cost-effective alternative for the delivery of transition care. In emerging adults with T1D, we aim to assess the effectiveness of group education visits compared with usual care on HbA1c, T1D-related complications, psychosocial measures and cost-effectiveness after the transfer to adult care.Methods and analysisIn a multisite, assessor-blinded, randomised, two-arm, parallel-group, superiority trial, 212 adolescents with T1D (ages 17 years) are randomised to 12 months group education versus usual T1D care before transfer to adult care. Visits in the active arm consist of group education sessions followed by usual T1D care visits every 3 months. Primary outcome is change in HbA1c measured at 24 months. Secondary outcomes are delays in establishing adult diabetes care, T1D-related hospitalisations and emergency department visits, severe hypoglycaemia, stigma, self-efficacy, diabetes knowledge, transition readiness, diabetes distress, quality of life and cost-effectiveness at 12 and 24 months follow-up. Analysis will be by intention-to-treat. Change in HbA1c will be calculated and compared between arms using differences (95% CI), along with cost-effectiveness analysis. A similar approach will be conducted to examine between-arm differences in secondary outcomes.Ethics and disseminationThe study was approved by McGill University Health Centre Research Ethics Board (GET-IT/MP-37-2019-4434, version ‘Final 1.0 from November 2018). Study results will be disseminated through peer-reviewed publications.Trial registration number NCT03703440.

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Insulin regimens, diabetes knowledge, quality of life, and HbA1c in children and adolescents with type 1 diabetes

Cited by 18 publications

References 33 publications

Improvement in glycemic control through changes in insulin regimens: findings from a Japanese cohort of children and adolescents with type 1 diabetes

Improvement in glycemic control through changes in insulin regimens: findings from a Japanese cohort of children and adolescents with type 1 diabetes

Mortality in type 1 diabetes diagnosed in childhood in Northern Ireland during 1989-2012: A population-based cohort study

Group education for adolescents with type 1 diabetes during transition from paediatric to adult care: study protocol for a multisite, randomised controlled, superiority trial (GET-IT-T1D)

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