Premium
Comparable glycemic outcomes for pediatric type 1 diabetes patients in metropolitan and non‐metropolitan regions of Western Australia: A population‐based study
Author(s) -
Joshi Kiranjit K,
Haynes Aveni,
Smith Grant,
Jones Timothy W,
Davis Elizabeth A
Publication year - 2018
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.12550
Subject(s) - medicine , metropolitan area , glycemic , population , type 1 diabetes , type 2 diabetes , diabetes mellitus , environmental health , pediatrics , endocrinology , pathology
Background Pediatric patients diagnosed with type 1 diabetes ( T1D ) in Western Australia ( WA ) are managed by a single, specialist multidisciplinary diabetes service based at a central tertiary hospital in the capital city, Perth, which provides outreach care in regional centers. Objective To investigate the hypothesis that outcomes for a contemporary, population‐based pediatric T1D cohort, managed by a single tertiary service are similar for metropolitan and non‐metropolitan patients using this model of care. To confirm that the cohort is indeed population based, a secondary aim of the study was to determine the case ascertainment of the Western Australian Children's Diabetes Database ( WACDD ). Methods Data for all T1D patients aged <18 years, who attended the diabetes clinics (metropolitan and non‐metropolitan), at least once in 2014, were extracted from the WACDD and outcomes including HbA1c and severe hypoglycemia ( SH ) rates analyzed. Results In 2014, a total of 1017 patients (492 females, 525 males) attended the diabetes clinics (54% metropolitan and 46% non‐metropolitan). After adjusting for age, sex, diabetes duration, and insulin regimen, region of clinic was not a significant predictor of mean HbA1c or SH rate. The case ascertainment of the WACDD was estimated to be 99.9% complete for children diagnosed with T1D aged <15 years between 2002 and 2012. Conclusions This study reports similar glycemic outcomes for patients attending diabetes clinics in metropolitan and non‐metropolitan areas of WA , suggesting that a model of care provided as outreach from a specialized diabetes service is effective in achieving equitable glycemic outcomes.