The influence of age, gender, insulin dose, BMI, and blood pressure on metabolic control in young patients with type 1 diabetes

Pediatr Diabetes. 2015 Dec;16(8):581-6. doi: 10.1111/pedi.12219. Epub 2014 Oct 1.

Abstract

Objective: To explore the relationship between certain clinical variables and metabolic HbA1c at diagnosis correlated to HbA1c at follow-up (p < 0.001). There was a clear gender difference regarding HbA1c. Girls had higher values both at diagnosis and at follow-up (p < 0.001). Girls also had lower BMI and pH at diagnosis than boys (p < 0.001). In contrast, girls with the highest body mass index (BMI) at follow-up had higher mean HbA1c at follow-up in 2010 (p < 0.001). Having a mother and/or a father with high BMI implied higher HbA1c at diagnosis (p < 0.003).

Conclusions: HbA1c at diagnosis seems to predict metabolic control years later. There is a gender difference at diagnosis as female patients have higher HbA1c than males at diagnosis as well as at follow up. As metabolic control is very much correlated to complications there is a need to early identify patients at risk of poor metabolic control. Even though we do not know whether a high HbA1c level is mainly due to severity of the disease or to behavioral patterns, new ways to treat and support these children, especially girls, are needed.

Keywords: HbA1c; children; gender; metabolic control; quality register; type 1 diabetes.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Blood Pressure
  • Body Mass Index
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 1 / therapy
  • Female
  • Glycated Hemoglobin / metabolism*
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Infant
  • Insulin / administration & dosage*
  • Linear Models
  • Logistic Models
  • Male
  • Sex Factors
  • Sweden / epidemiology

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • hemoglobin A1c protein, human