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Deteriorating diabetic control through adolescence—do the origins lie in childhood?
Author(s) -
Dabadghao P.,
Vidmar S.,
Cameron F. J.
Publication year - 2001
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2001.00593.x
Subject(s) - medicine , body mass index , metabolic control analysis , diabetes mellitus , endocrinology , body weight
Aims To determine whether intra‐individual measures of diabetes control deteriorated through adolescence and whether HbA 1c in late childhood was predictive of HbA 1c after adolescence. Methods Retrospective analysis of sequential 3–6 monthly data including HbA 1c , height, weight, and total daily insulin dosage in 118 patients with Type 1 diabetes aged between 8.00 and 17.99 years between 1983 and 1999. Results In females mean body mass index (BMI) increased sharply during adolescence but there was no significant increase in males. The mean total daily dose of insulin/weight (TDDI/W) increased sharply for females through puberty. Males exhibited a constant rate of increase in mean TDDI/W from pre‐ to post‐puberty. There was a constant increase in mean HbA 1c for females, with an estimated increase from pre‐ to post‐puberty of 0.92%. In males there was only a slight increase from pre‐ to peri‐puberty and no change subsequently. Comparing pre‐puberty (8–9.99 years) and post‐puberty (15–17.99 years) in the total group, 47% of patients remained in the same mean HbA 1c grouping, 37% had worsened control and 16% had improved control. Analysis of change in the absolute value of mean HbA 1c showed that the majority of patients had mean HbA 1c values that remained within ± 1% (54%) or ± 2% (82%) from pre‐ to post‐puberty. A significant proportion showed significantly worsening control with only a minority showing improved metabolic control from pre‐ to post‐puberty. Conclusions The likelihood of a significant improvement in HbA 1c from late childhood to adolescence is remote, with the majority of patients having either constant or deteriorating metabolic control. Diabet. Med. 18, 889–894 (2001)