Objective: The majority of adolescents with type 1 diabetes have poor glycemic control, calling for an action to be taken. The aim of this study was to identify the determinants of poor glycemic control among adolescents with type 1 diabetes.

Methods: Data were collected for all adolescents with type 1 diabetes (age < 20 years), who attended diabetes clinics at one hospital, and had at least one result of HbA1c performed during the study year. The average level of HbA1c was calculated from all the HbA1c results collected over one year. Glycemic control was defined as poor if the HbA1c was >8%. Variables studied were gender, age, age at diagnosis, diabetes duration, annual clinic attendance, frequency of blood glucose monitoring, healthy eating, medication adherence, and frequency of HbA1c performance over one year.

Results: The study included 78 adolescents with type 1 diabetes (47.4% males). Mean age was 15.4+2.0 years, mean age at diagnosis was 9.0+3.6 years, and mean duration of diabetes was 6.6+3.8 years. The mean of the average level of HbA1c was 10.2+1.9%, and 84.6% had HbA1c >8%. Mean frequency of HbA1c performance was twice per year, and mean annual clinic attendance was three visits. Poor glycemic control was significantly associated with female gender (p<0.05). Healthy eating, medication adherence, and frequent HbA1c performance (> 3 per year) were significantly associated (p<0.001) with better glycemic control (HbA1c<8%). With regression analysis, healthy eating, medication adherence and HbA1c performance remained as the major determinants of the glycemic control.

Conclusions: The overall glycemic control in adolescents with type 1 diabetes was poor, putting them at high risk of developing diabetes complications at an early stage of life. Healthy behavior was a major determinant of glycemic control. Behavioral healthy intervention strategies should be integrated in the management plan of diabetes care to improve glycemic control and reduce diabetes complications in this vulnerable group.

Disclosure

A.M.A. Aladsani: None.

© 2019 by the American Diabetes Association.
2019
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