Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA.
Diabetes Care. 2012 Jun;35(6):1219-24. doi: 10.2337/dc11-2163. Epub 2012 Apr 3.
To test models of unidirectional and bidirectional change between treatment adherence and glycemic control in youth with type 1 diabetes.
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.
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.
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.
检验青少年 1 型糖尿病患者治疗依从性和血糖控制之间单向和双向变化的模型。
我们进行了一项为期 2 年的多中心纵向研究，共招募了 225 名青少年前期（9-11 岁）的 1 型糖尿病患儿，描述了血糖监测频率（BGMF）测量的治疗依从性和糖化血红蛋白（HbA1c）测量的血糖控制在青少年过渡期的相互影响。
在 2 年期间，HbA1c 从 8.2%增加到 8.6%（P<0.001），BGMF 从每天 4.9 次减少到 4.5 次（P<0.02）。BGMF 斜率的变化预测了 HbA1c 的变化。在控制了协变量后，HbA1c 的变化（增加）与 BGMF 的变化（减少）相关，变化幅度为 1.26（P<0.001）。
治疗依从性（BGMF）下降对青少年早期血糖控制的影响程度可能比观察到的青少年晚期更大。BGMF 为青少年期过渡期间 1 型糖尿病的血糖控制提供了一种有效的靶向管理工具。
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