Decline in treatment adherence for type 1 diabetes greater among young adolescents

Major consequences surround pediatric patients who are transitioning to adolescence, with a lower frequency of blood glucose monitoring than older adolescents.

Researchers conducted a 2-year longitudinal, multisite study of 225 patients with type 1 diabetes, aged 9 to 11 years, to examine the influences on glycemic control as children transition into adolescence.

“To our knowledge, no study with pediatric patients who are transitioning to adolescence has evaluated 1) the rate at which treatment adherence predicts change in glycemic control; or, 2) whether the adherence-glycemic control relationship is bidirectional, that is, involving mutual influence,” the researchers wrote.

Researchers paid participants $5 for supplying their meter or logbook at the time of their study visit. The logbooks were available from 98.7% participants at baseline, 97.8% at 1 year and 96.5% at 2 years.

The results demonstrated an average HbA1c of 8.2 (95% CI, 8.0-8.4), and an average slope over time of 0.2 (95% CI, 0.1-0.3), which concluded that a participant following the average trajectory for HbA1c had an initial HbA1c value of 8.2%, a total 2-year change in HbA1c of 0.4%.

The blood glucose monitoring frequency reflects a decrease in average intercept of 4.9 (95% CI, 4.7-5.21), from the average slope over time to –0.2 (95% CI, –0.0 to –0.3).

The average daily blood glucose monitoring frequency for all participants was 5.01 at baseline, 4.68 at 1 year and 4.74 at 2 years.

“Our findings documented significant deterioration in glycemic control over a 2-year period as youth with type 1 diabetes transition to adolescence,” the researchers wrote.

Future studies should be considered to address a broader sample of participants during a longer period of time.

Disclosure: The researchers report no relevant financial disclosures.

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Source: Rausch JR. Diabetes Care. 2012;doi:10.2337/dc11-2163.