Type 1 diabetes (T1D) management has become increasingly technologically advanced with the use of insulin pumps, continuous glucose monitoring and diabetes data management software. These technologies are underutilized although there is evidence for improvement in A1C when adults review blood glucose trends with their diabetes team in between clinic visits. The primary objective of this study was to assess if a correlation exists between A1C within target (≤ 7.5%) and frequency of contact of pediatric patients with the diabetes team between clinic visits. Secondary objectives included determining barriers to contact and change in A1C from baseline to end of study. T1D patients using an insulin pump for one year or more were approached to participate. Participants completed a questionnaire to assess diabetes management over the past year. A1C and contact with the diabetes team between clinic visits for insulin adjustments in the past year were collected. One hundred and seventy six participants were enrolled, 46% female, with a mean age of 12.9 (± 3.8) years. Mean duration of T1D was 6.7 (± 3.7) years with a mean duration of pump use of 4.5 (± 3.1) years. Mean A1C at baseline was 8.1% (± 1). One hundred and sixteen (66%) patients contacted the diabetes team for insulin adjustments between clinic visits with a mean of 1.2 (± 1.7) contacts, 90% by e-mail. There was no significant relation between target A1C and frequency of contact (p>0.05). Decreased frequency of contact was associated with increased age (r=0.20, p = 0.01) and longer duration of pump use (r=0.17, p = 0.02). Barriers to contact included being too busy (41%) and technical problems with software (39%).
In conclusion, there was no significant relationship between frequency of contact of pediatric patients with the diabetes team and A1C. The low frequency of contact raises the importance of defining strategies to increase patient contact which has the potential to improve diabetic control.
F. Babalola: None. A. Ens: None. P.H. Gallego: None. R.I. Stein: None. C. Clarson: None.