Retrospective review of care and outcomes in young adults with type 1 diabetes

Wills, C.J.; Scott, A. R.; Swift, Peter; Davies, Melanie J.; Mackie, Anna; Mansell, Peter

doi:10.1136/bmj.327.7409.260

Cited by 68 publications

(80 citation statements)

References 4 publications

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“…In our cohort, the poorer glycemic control was largely confined to adolescent patients. While adolescents, in general, tend to experience worse glycemic control than younger children [12], immigrant youth may face additional challenges as they struggle with the normal adolescent task of fitting in with their peers. Socioeconomic factors may also play a role in poor diabetes control in Somali adolescents.…”

Section: Discussionmentioning

confidence: 99%

Understanding Cultural Beliefs in Families of Somali Children with Diabetes in the Twin Cities, Minnesota

et al. 2015

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Describe cultural beliefs related to diabetes in Minnesota Somali children with type 1 diabetes (T1D), and compare their diabetes control to that of non-Somali children with diabetes. A cross-sectional study involving Somali children ≤ 19 years with T1D at the University of Minnesota Masonic Children's Hospital and Children's Hospitals and Clinics of Minnesota. A survey was administered to parents of all participants and to children aged ≥ 12 years. Data were collected by history and from the medical record. Twenty-five Somali children participated, with 24 parent-child pairs (2 siblings). Mean participant age was 12.2 ± 5.2 (36% female). Seventy-one percent of parents indicated the child was "the same as before" other than having to do diabetes cares. Families were coping well, and the child was not treated differently than siblings. Performance of routine cares was described as the hardest part about having diabetes, but this was not related to traditional culture or religion. One notable exception was difficulty performing carbohydrate counting on Somali foods. Respondents were appreciative of the education provided by the diabetes team. Less than 10% used herbal supplements in addition to insulin. Mean HbA1c in Somali children was higher than the overall pediatric clinic average, 9.5 ± 1.6 % versus 8.8 ± 1.6 (p = 0.01). The difference was largely due to adolescent patients. The majority of Somali families cope well with diabetes and have a positive attitude towards the diabetes education. Glycemic control in adolescents is worse than in non-Somali peers. There is a need for culture-specific dietary instruction materials.

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Section: Discussionmentioning

confidence: 99%

Understanding Cultural Beliefs in Families of Somali Children with Diabetes in the Twin Cities, Minnesota

et al. 2015

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“…2 The mean HbA 1C of 8.4% achieved in our study is the same as that in DAFNE trial 12 and in the conventional therapy cohort in DCCT 2 and better than that reported (9.4%) in the multicentre study. 4 Important factors were better clinic attendance, more frequent and more structured visits, regular HbA 1C levels, and close collaboration involving the entire diabetes care team and users.…”

Section: Discussionmentioning

confidence: 99%

The Alphabet Strategy and standards of care in young adults with type 1 diabetes

Gholap

Pillai

Virmani³

et al. 2006

Diabetes & Vascular Disease

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T he Alphabet Strategy is a mnemonic-based approach to assist commitment to important aspects of diabetes care: Advice; Blood pressure lowering; Cholesterol and creatinine control; Diabetes control; Eye examination; Foot examination; and use of Guardian drugs. This strategy reported high standards of care of patients with type 2 diabetes. This study assesses the impact of the Alphabet Strategy on diabetes management in young adults with type 1 diabetes and compared data with those of a recently published multicentre study. Results were analysed using the chi-square test and Student's t-test.Data were collected retrospectively from 68 patients with type 1 diabetes aged 16-25 years attending the George Eliot Hospital (GEH) adolescent diabetes clinic and who were being managed as per The Alphabet Strategy.Standards of diabetes care in the GEH clinic were better than those reported in the multicentre study. GEH versus multicentre study: clinic non-attendance 12% vs. 24.6%: mean HbA 1C % 8.4 vs. 9.5, p<0.001: screening rates; hypertension 100% vs. 88%, p<0.05; nephropathy 80% vs. 56%, p<0.01; retinopathy 98% in GEH clinic: prevalence of complications; nephropathy 5% vs. 21%, p<0.02; retinopathy 24% vs. 28%, not significant.In conclusion, we found regular clinic visits and separate adolescent clinics improve glycaemic control. The Alphabet Strategy may be considered an effective approach in monitoring/screening and attaining targets in young adults with type 1 diabetes. Br J Diabetes Vasc Dis 2006;6:168-70

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“…No Australian data are available on rates of successful transition from paediatric to adult care and association with diabetes outcomes in young adults. Such data would seem important to gather in view of data suggesting poor clinical and psychiatric outcomes in young adults with type 1 diabetes 68,81 , 82 . Also, standardised Australian mortality data are also not available for children and adolescents with diabetes.…”

Section: Discussionmentioning

confidence: 99%

Contemporary Australian outcomes in childhood and adolescent type 1 diabetes: 10 years post the Diabetes Control and Complications Trial

Ambler

Fairchild

Craig

et al. 2006

J Paediatrics Child Health

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The reporting of the results of the Diabetes Control and Complications Trial in 1993 has led to a major reappraisal of management practices and outcomes in type 1 diabetes in children and adolescents. A considerable body of outcome data has been generated from Australia in this post-Diabetes Control and Complications Trial era relating to incidence, metabolic control, growth, hypoglycaemia, microvascular and macrovascular complications, cognition, behaviour and quality of life. These data are important in planning future management strategies and resource allocation and as a basis for future research.

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Retrospective review of care and outcomes in young adults with type 1 diabetes

Cited by 68 publications

References 4 publications

Understanding Cultural Beliefs in Families of Somali Children with Diabetes in the Twin Cities, Minnesota

Understanding Cultural Beliefs in Families of Somali Children with Diabetes in the Twin Cities, Minnesota

The Alphabet Strategy and standards of care in young adults with type 1 diabetes

Contemporary Australian outcomes in childhood and adolescent type 1 diabetes: 10 years post the Diabetes Control and Complications Trial

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