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Characteristics of glycemic control in young children with type 1 diabetes
Author(s) -
Kaufman Francine Ratner,
Austin Juliana,
Lloyd Jessica,
Halvorson Mary,
Carpenter Sue,
Pitukcheewat Pisit
Publication year - 2002
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1034/j.1399-5448.2002.30402.x
Subject(s) - medicine , diabetic ketoacidosis , diabetes mellitus , hypoglycemia , glycemic , type 1 diabetes , ketoacidosis , insulin , diabetes management , type 2 diabetes , pediatrics , retrospective cohort study , endocrinology
Abtract: Background: The Diabetes Control and Complications Trial (DCCT) demonstrated that the rate‐limiting step to the intensification of diabetes management in adolescents and adults was hypoglycemia. Young children were presumed to be at even greater risk for hypoglycemia with severe consequences, particularly if they had HbA1c levels < 8%. Subjects: A retrospective chart review was performed on 148 patients with type 1 diabetes on insulin injection therapy who were < 8 yr of age (mean age 5.7 ± 1.5, mean diabetes duration 3.0 ± 1.4 yr) followed quarterly from July 1999 to June 2001. Methods: The subjects were divided into two groups based on their mean HbA1c values (< 8 vs. ≥ 8%) averaged over the 2‐yr time period. The following variables were analyzed comparing the two groups: age, duration of diabetes, insulin dose, severe hypoglycemic episodes, episodes of diabetic ketoacidosis (DKA), percentage of glucose levels above, within, and below the target range, and number of diabetes home‐management competencies obtained. Results: Patients with HbA1c < 8% spent more time within target range (40.0 vs. 29.5%, p = 0.0001) and less time above their target range (36.9 vs. 51.2%, p = 0.0003). There was no difference in the percentage of glucose levels below target (23.2 vs. 19.4%, p = NS), percentage of severe hypoglycemic episodes (3 vs. 7 episodes per 100 patient‐yr, p = NS), or episodes of DKA (1 vs. 3 episodes per 100 patient‐yr, p = NS) between the two groups. Subjects with lower HbA1c levels had acquired more home‐management competencies (4.0 vs. 3.5, p = 0.01). Conclusions: If families are competent in fundamental diabetes management, young children can achieve HbA1c levels < 8.0% without increasing the risk of hypoglycemia.