Identifying HbA1c trajectories and modifiable risk factors of trajectories in 5- to 9-year-olds with recent-onset type 1 diabetes from the United States.

Creator(s)

Susana R. Patton
Keith Feldman, Children's Mercy HospitalFollow
Shideh Majidi
Amy Noser
Mark A. Clements, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

9-2021

Identifier

DOI: 10.1111/dme.14637

Abstract

OBJECTIVE: To explore glycated haemoglobin (HbA1c) patterns in 5- to 9-year-olds in the recent-onset period of type 1 diabetes and identify parent psychosocial factors that may predict children's HbA1c trajectory using a prospective, longitudinal design.

RESEARCH DESIGN AND METHODS: We measured family demographics and parent psychosocial factors at baseline. We collected HbA1c levels from children every 3 months for up to 30 months. Deriving several features around HbA1c trends, we used k-means clustering to group trajectories and linear and logistic regressions to identify parent psychosocial predictors of children's HbA1c trajectories.

RESULTS: The final cohort included 106 families (48 boys, mean child age 7.50 ± 1.35 years and mean diabetes duration 4.71 ± 3.19 months). We identified four unique HbA1c trajectories in children: high increasing, high stable, intermediate increasing and low stable. Compared to a low stable trajectory, increasing parent-reported hypoglycaemia fear total score was associated with decreased odds of having a high stable or intermediate increasing trajectory. Increasing parent-reported diabetes-specific family conflict total score was associated with increased odds of having a high stable or intermediate increasing trajectory.

CONCLUSIONS: We are the first to identify distinct HbA1c trajectories in 5- to 9-year-olds with recent-onset type 1 diabetes as well as parent psychosocial factors that may predict high stable or increasing trajectories and could represent future treatment targets.

Journal Title

Diabetic medicine : a journal of the British Diabetic Association

Volume

38

Issue

9

First Page

14637

Last Page

14637

Keywords

children and adolescents; education; psychological aspects; self-management

Comments

Grant support

• R01 DK100779/DK/NIDDK NIH HHS/United States
• NH/NIH HHS/United States
• NH/NIH HHS/United States

Recommended Citation

Patton SR, Feldman K, Majidi S, Noser A, Clements MA. Identifying HbA1c trajectories and modifiable risk factors of trajectories in 5- to 9-year-olds with recent-onset type 1 diabetes from the United States. Diabet Med. 2021;38(9):e14637. doi:10.1111/dme.14637