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The role of socio‐economic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: an Italian multicentre survey
Author(s) -
Gesuita Rosaria,
Skrami Edlira,
Bonfanti Riccardo,
Cipriano Paola,
Ferrito Lucia,
Frongia Paola,
Iafusco Dario,
Iannilli Antonio,
Lombardo Fortunato,
Mozzillo Enza,
Paleari Renata,
Rabbone Ivana,
Sabbion Alberto,
Salvatoni Alessandro,
Scaramuzza Andrea,
Schiaffini Riccardo,
Sulli Nicoletta,
Toni Sonia,
Carle Flavia,
Cherubini Valentino
Publication year - 2017
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 - 10.1111/pedi.12378
Subject(s) - medicine , logistic regression , odds ratio , confidence interval , body mass index , demography , socioeconomic status , type 2 diabetes , metabolic control analysis , diabetes mellitus , insulin , pediatrics , environmental health , endocrinology , population , sociology
Objective To identify the role of the family's socio‐economic and clinical characteristics on metabolic control in children and adolescents with type 1 diabetes. Methods In this cross‐sectional, multicentre study, 768 subjects with type 1 diabetes under 18 years of age were consecutively recruited from January 2008 to February 2009. Target condition was considered for HbA 1c values <7.5% (<58 mmol/mol). A multiple correspondence analysis ( MCA ) was performed to analyze the association between the socio‐economic and clinical characteristics of the participants. A logistic regression analysis was performed to identify factors associated with the subjects metabolic control. In both analyses, the family's socio‐economic status was represented, measured by the Hollingshead Four‐Factor Index of Social Status ( SES ) or by parental years of education. Results A total of 28.1% of subjects reached target HbA1c values. The MCA identified a strong association between at‐target condition and several factors: high levels of SES or high levels of parental education, the use of the carbohydrate counting system, the use of insulin pumps, the use of the insulin delivery system over a short period of time, a normal body mass index. The logistic regression analysis showed that SES and the mother's years of education were significantly associated with the target condition [odds ratio ( OR ): 1.01, 95% confidence interval ( CI ): 1.01–1.03, p = 0.029; OR : 1.05, 95% CI : 1.01–1.10, p = 0.027, respectively). Conclusions Personal, clinical, and family characteristics were found to be associated with HbA 1c target. Their identification can be crucial in addressing strategies to optimize metabolic control and improve diabetes management.