Determination of Risk for Suboptimal Glycemic Control in New-Onset Type 1 Diabetes

Background: Most youth with type 1 diabetes (T1D) do not meet current ADA recommendations for A1C, thus, it is important to identify at diagnosis, those at-risk for later suboptimal glycemic control (A1C ≥9.5%) and complications.

Methods: The Risk Index for Poor Glycemic Control (RI-PGC) was administered to 266 parents during children’s (ages <1-19 years) routine new onset T1D visit. The RI-PGC provides a single score (range = 0-9, higher scores = higher risk) based on psychosocial factors (e.g., insurance, child mood, parent stress/anxiety) to classify risk as “Low,” “Moderate,” or “High” in the 1-4 years after diagnosis. Demographic data and DKA occurrence at diagnosis were also collected.

Results: Of 266 children with new onset T1D (Mage 9.98 ± 4.42 years; 52% male; 68% Caucasian), 18.8% and 28.6% were Moderate and High Risk, respectively. DKA at onset (n=157; 59%) was significantly correlated with risk score (r=0.888, p<0.001). Children in DKA at onset were more than twice as likely to score high on RI-PGC (p=0.009; Table).

Conclusions: We use the RI-PGC in a prevention program to identify risk of future suboptimal glycemic control. These results are consistent with the only other study (Schwartz et al., 2014) to examine risk-most children were Low Risk and more children were High Risk than Moderate Risk. Presence of DKA at onset may be another predictor of future suboptimal glycemic control, DKA episodes, and complications.