Changes in treatment adherence and glycemic control during the transition to adolescence in type 1 diabetes

Joseph R Rausch, Korey K Hood, Alan Delamater, Jennifer Shroff Pendley, Jennifer M Rohan, Grafton Reeves, Lawrence Dolan, Dennis Drotar, Joseph R Rausch, Korey K Hood, Alan Delamater, Jennifer Shroff Pendley, Jennifer M Rohan, Grafton Reeves, Lawrence Dolan, Dennis Drotar

Abstract

Objective: To test models of unidirectional and bidirectional change between treatment adherence and glycemic control in youth with type 1 diabetes.

Research design and methods: We conducted a 2-year longitudinal, multisite study of 225 youth with type 1 diabetes recruited at the cusp of adolescence (aged 9-11 years) to describe the mutual influences of glycemic control as measured by HbA(1c) and treatment adherence as measured by blood glucose monitoring frequency (BGMF) during the transition to adolescence.

Results: HbA(1c) increased from 8.2 to 8.6% (P < 0.001) and BGMF decreased from 4.9 to 4.5 checks per day (P < 0.02) during the 2-year period. Changes in the BGMF slope predicted changes in HbA(1c). A change (increase) in HbA(1c) was associated with a change (decrease) in BGMF of 1.26 (P < 0.001) after controlling for covariates.

Conclusions: The magnitude of the effect of declining treatment adherence (BGMF) on glycemic control in young adolescents may be even greater than declines observed among older adolescents. BGMF offers a powerful tool for targeted management of glycemic control for type 1 diabetes during the critical transition to adolescence.

Figures

Figure 1
Figure 1
Average values of HbA1c at each time point.
Figure 2
Figure 2
Average values of BGMF at each time point.

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Source: PubMed

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