Treatment adherence and BMI reduction are key predictors of HbA1c one year after diagnosis of childhood Type 2 Diabetes in UK

Toby P Candler, Osama Mahmoud, Richard M Lynn, Abdalmonen A Majbar, Timothy G Barrett, Julian Hamilton-Shield

Research output: Contribution to journalArticle (Academic Journal)

4 Citations (Scopus)
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Abstract

BACKGROUND: Type 2 Diabetes (T2DM) is increasing in childhood especially among females and South-Asians.

OBJECTIVE: To report outcomes from a national cohort of children and adolescents with T2DM one year following diagnosis SUBJECTS AND METHODS: Clinician reported, one-year follow-up of a cohort of children (<17years) diagnosed with T2DM reported through British Paediatric Surveillance Unit (April 2015-April 2016).

RESULTS: One hundred (94%) of 106 baseline cases were available for review. Of these, five were lost to follow up and one had a revised diagnosis. Mean age at follow up was 15.3 years. Median BMI SDS was 2.81 with a decrease of 0.13 SDS over a year. HbA1c <48mmol/mol (UK target) was achieved in 38.8%. logHbA1c was predicted by clinician reported compliance and attendance concerns (β=0.12 p=<0.0001) and change in BMI SDS at 1-year (β=0.13, p=0.007). In over 50%, clinicians reported issues with compliance and attendance. Mean clinic attendance was 75%. Metformin was the most frequently used treatment at baseline (77%) and follow-up (87%). Microalbuminuria prevalence at 1-year was 16.4% compared to 4.2% at baseline and was associated with a higher HbA1c compared to those without microalbuminuria (49 vs 60 mmol/mol, p=0.03).

CONCLUSIONS: Adherence to treatment and a reduction in BMI appear key to better outcomes a year after T2DM diagnosis. Retention and clinic attendance are concerning. The prevalence of microalbuminuria has increased four-fold in the year following diagnosis and was associated with higher HbA1c. This article is protected by copyright. All rights reserved.

Original languageEnglish
Number of pages7
JournalPediatric Diabetes
Early online date11 Oct 2018
DOIs
Publication statusE-pub ahead of print - 11 Oct 2018

Keywords

  • type 2 diabetes
  • children
  • adolescent
  • obesity
  • complications

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