medwireNews: Among adolescents with type 1 diabetes, those with better self-care are more likely to have favorable glycated hemoglobin (HbA1c) trajectories into early adulthood, suggest study findings reported by Kevin Marks (Aarhus University, Denmark) at the 58th EASD Annual Meeting in Stockholm, Sweden.
The researchers measured the degree of diabetes self-care – defined as the agreed-upon plan comprising efforts to fulfil an array of diabetes recommendations in collaboration with healthcare providers – as reported by 671 Danish adolescents aged 10–17 years and their caregivers.
Example questions on the Adherence in Diabetes Questionnaire (ADQ) included how often participants measured their blood glucose before each meal, adjusted insulin based on various factors, and remembered to carry “fast sugar,” with answers based on a Likert scale ranging from 1 (never) to 5 (always) points.
The adolescents were assigned to one of four groups based on longitudinal HbA1c data from 2009–2020 registries. These comprised a favorable HbA1c trajectory, which decreased gradually from the age of around 12 to 27 years (group 1), a slight increase followed by a gradual decrease (group 2), and two higher-risk categories, namely a steep increase followed by a small reduction over time (group 3), and a steep increase followed by a steep decrease (group 4).
Marks said that an estimated 73% of the study population were categorized into one of the three less favorable HbA1c categories, with 34% falling into one of the high-risk groups.
Multivariate prediction models demonstrated that higher ADQ scores (indicating better diabetes self-care), as reported by both adolescents and caregivers, were associated with a reduced likelihood of belonging to a high-risk HbA1c trajectory group.
However, the presenter highlighted that caregiver-reported ADQ scores may be more sensitive than those reported by adolescents. For instance, caregiver-reported scores significantly predicted which participants would belong to the moderate-risk group 2, but adolescent-reported scores did not.
Based on these findings, Marks concluded that healthcare providers should always involve the caregivers when discussing diabetes self-care.
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