Conference Resources | Abstracts
September 3
rd
– 6
th
, 2014 | Toronto, Canada |
124
P30
A four-year longitudinal analysis of Hgb A1C in youth with type 1 diabetes
H. Starkman
1
, R. Bustami
2
1
Goryeb Children's Hospital, BD Diabetes Center for Children & Adolescents, Morristown, United
States,
2
Atlantic Center for Research, Morristown, United States
Background:
There have been a few, mostly small and non-longitudinal analyses of HgbA1C (A1C)
values in youth with type 1 diabetes. These studies have reported A1C differences between diabetes
centers, but have not focused on medical providers within each center. We analyzed A1C data over
four years at a regional pediatric diabetes center, focusing on longitudinal patterns.
Methods:
Age, sex, diabetes duration, treating physician and A1C values for visits from 2009-2012
were analyzed (Simens DCA, Labdaq Lite). Subjects with at least one A1C measure for each of the
four years were included. Those with diabetes duration of < 1 year were excluded to eliminate subjects
with residual B cell function. The last A1C performed annually was utilized. Comparisons of A1C by
physician and by year were made using the Kruskal-Wallis test. Paired comparisons of A1C by year
were made using the Friedman´s test for related samples. Proportions of patients meeting ADA targets
were compared by the One-Sample Binomial Test.
Results:
539 subjects, mean age 13.0 years (SD = 3.9), mean diabetes duration 7.8 years (SD 4.5)
were included. A1C's over the study period compared favorably with reports from other centers (p<
0.001). The cohort had a trend of rising A1C over 4 years (p=0.001), concomitant with routine medical
visits decreasing from a mean of 4 to 3 visits annually. Analysis of the cohort by treating physician,
showed a persistent and consistent significant difference in A1C, not related to provider experience
(p< 0.05), although these cohorts did not differ in age, number of visits/year or diabetes duration.
Conclusions:
Our data reaffirm the value of analyzing and reviewing longitudinal A1C data at
pediatric diabetes centers. The variation in metabolic control by medical provider, as well as trend
towards higher A1C during years with less diabetes outpatient visits provide an opportunity for
effective intervention to improve outcomes for youth with type1 diabetes.
