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Children and adolescents with type 1 diabetes and high HbA1c – a neurodevelopmental perspective
Author(s) -
Nylander Charlotte,
Toivonen Henri,
Nasic Salmir,
Söderström Ulf,
Tindberg Ylva,
Fernell Elisabeth
Publication year - 2013
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12128
Subject(s) - medicine , percentile , type 2 diabetes , perspective (graphical) , diabetes mellitus , metabolic control analysis , pediatrics , type 1 diabetes , population , endocrinology , environmental health , computer science , statistics , mathematics , artificial intelligence
Aim To examine the association between neurodevelopmental problems and high HbA1c among paediatric patients with type 1 diabetes. Methods A population‐based study was performed among patients with type 1 diabetes (5–16 years) in two Swedish counties (n = 233). The Five to Fifteen ( FTF ) questionnaire targeted neurodevelopmental qualities. Scores above the 90th percentile in the various domains are considered as definitive problems and scores above the 75th percentile as mild. FTF scores were compared with regard to HbA1c ≤73 mmol/mol and >73 mmol/mol (8.0%). Results The response rate was 190 (82%). Neurodevelopmental problems were not overrepresented among patients in general. Memory and learning problems were associated with HbA1c >73 mmol/mol ( p = 0.01) . This correlation was especially seen in adolescents (12–16 years) where mild executive problems (adj OR 3.1), definite memory problems (adj OR 5.0) and definite learning problems (adj OR 5.0) were associated with HbA1c >73 mmol/mol after adjustment for gender, diabetes duration and age of onset. Conclusion Our findings that high HbA1c is more common in adolescent diabetes patients with neurodevelopmental problems generate the hypothesis that these problems might precede poor metabolic control. If so, early detection of neurodevelopmental problems would allow individually tailored treatment that may improve metabolic control and prevent complications.