Mazarello Paes, V;
Barrett, JK;
Dunger, DB;
Gevers, EF;
Taylor-Robinson, DC;
Viner, RM;
Stephenson, TJ;
(2020)
Factors predicting poor glycaemic control in the first two years of childhood onset type 1 diabetes in a cohort from East London, UK: Analyses using mixed effects fractional polynomial models.
Pediatric Diabetes
, 21
(2)
pp. 288-299.
10.1111/pedi.12950.
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Abstract
Background/Objective: Poor early glycemic control in childhood onset type 1 diabetes (T1D) is associated with future risk of acute and chronic complications. Our aim was to identify the predictors of higher glycated hemoglobin (HbA1c) within 24 months of T1D diagnosis in children and adolescents. Methods: Mixed effects models with fractional polynomials were used to analyze longitudinal data of patients <19 years of age, followed from T1D diagnosis for up to 2 years, at three diabetes clinics in East London, United Kingdom. Results: A total of 2209 HbA1c observations were available for 356 patients (52.5% female; 64.4% non‐white), followed from within 3 months of diagnosis during years 2005 to 2015, with a mean ± SD of 6.2 ± 2.5 HbA1c observations/participant. The mean age and HbA1c at diagnosis were 8.9 ± 4.3 years and 10.7% ±4.3% (or expressed as mmol/mol HbA1c mean ± SD 92.9 ± 23.10 mmol/mol) respectively. Over the 2 years following T1D diagnosis, HbA1c levels were mostly above the National Institute for Health, Care and Excellence (NICE), UK recommendations of 7.5% (<58 mmol/mol). Significant (P < .05) predictors of poorer glycemic control were: Age at diagnosis (12‐18 years), higher HbA1c at baseline (>9.5%, ie, >80 mmol/mol), clinic site, non‐white ethnicity, and period (pre‐year 2011) of diagnosis. Additionally in univariable analyses, frequency of clinic visits, HbA1c at diagnosis, and type of insulin treatment regimen showed association with poor glycemic control (P < .05). Conclusions: Major risk factors of poorer glycemic control during 3‐24 months following childhood onset T1D are: diagnosis prior to 2011, higher HbA1c levels at baseline, age at diagnosis, non‐white ethnicity, and clinic site.
| Type: | Article |
|---|---|
| Title: | Factors predicting poor glycaemic control in the first two years of childhood onset type 1 diabetes in a cohort from East London, UK: Analyses using mixed effects fractional polynomial models |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/pedi.12950 |
| Publisher version: | https://doi.org/10.1111/pedi.12950 |
| Language: | English |
| Additional information: | © 2019 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10086720 |
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