| Temporal trends in the treatment of pediatric type 1 diabetes and impact on acute outcomes. | |
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MedLine Citation:
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PMID: 17307546 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate temporal trends in pediatric type 1 diabetes (T1DM) management and resultant effects on outcomes. STUDY DESIGN: Two pediatric T1DM cohorts were followed prospectively for 2 years and compared; Cohort 1 (N = 299) was enrolled in 1997 and Cohort 2 (N = 152) was enrolled in 2002. In both cohorts, eligible participants were identified and sequentially approached at regularly scheduled clinic visits until the target number of participants was reached. Main outcome measures were hemoglobin A1c (A1c), body mass index Z score (Z-BMI), and incidence rate (IR; per 100 patient-years) of hypoglycemia, hospitalizations, and emergency room (ER) visits. RESULTS: At baseline, Cohort 2 monitored blood glucose more frequently than Cohort 1 (> or = 4 times/day: 72% vs 39%, P < .001) and was prescribed more intensive therapy than Cohort 1 (> or = 3 injections/day or pump: 85% vs 65%, P < .001). A1c was lower in Cohort 2 than Cohort 1 at baseline (8.4% vs 8.7%, P = .03) and study's end (8.7% vs 9.0%, P = .04). The cohorts did not differ in Z-BMI (0.83 vs 0.79, P = .57) or IR of hospitalizations (11.2 vs 12.9, P = .38). Cohort 2 had lower IR of total severe hypoglycemic events (29.4 vs 55.4, P < .001) and ER visits (22.0 vs 29.3, P = .02). CONCLUSIONS: T1DM management intensified during the 5 years between cohorts and was accompanied by improved A1c and stable Z-BMI. Along with improved control, IR of severe hypoglycemia and ER visits decreased by almost 50% and 25%, respectively. |
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Authors:
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Britta M Svoren; Lisa K Volkening; Deborah A Butler; Elaine C Moreland; Barbara J Anderson; Lori M B Laffel |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of pediatrics Volume: 150 ISSN: 1097-6833 ISO Abbreviation: J. Pediatr. Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-02-19 Completed Date: 2007-03-27 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 0375410 Medline TA: J Pediatr Country: United States |
Other Details:
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Languages: eng Pagination: 279-85 Citation Subset: AIM; IM |
Affiliation:
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Pediatric and Adolescent Section, Joslin Diabetes Center, Boston, Massachusetts 02215, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Blood Glucose / analysis Blood Glucose Self-Monitoring Child Cohort Studies Diabetes Mellitus, Type 1 / diagnosis*, drug therapy* Emergency Service, Hospital / utilization Female Follow-Up Studies Forecasting Glucose Tolerance Test Hospitalization / statistics & numerical data Humans Hypoglycemia / epidemiology, prevention & control* Injections, Subcutaneous Insulin / administration & dosage*, adverse effects Male Probability Risk Assessment Severity of Illness Index Time Factors Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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5T32DK063702/DK/NIDDK NIH HHS; R01 DK046887-07/DK/NIDDK NIH HHS; R01DK046887/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 11061-68-0/Insulin |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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