Characteristics of adolescents with type 1 diabetes who exhibit adverse outcomes.

PURPOSE: This study seeks to determine differences in key characteristics between adolescents with type 1 diabetes who experience the adverse outcomes of poor glycemic control, hypoglycemic events, and hospitalizations due to their disease versus those who do not experience such events. A secondary purpose is to examine differences in outcomes for adolescents using insulin pumps versus daily insulin injections (>or=2).

METHODS

Data from 108 adolescents were divided according to glycemic control (HbA1c <8% vs >or=8%), hypoglycemic reactions and hospitalizations in the past year (0 vs >or=1 episode of each), and pump versus injection delivery of insulin. Within each grouping, body mass index, insulin dose, caloric intake, parental educational level, marital status, annual family income, race, and gender were compared. HbA1c level was examined in relation to the number of hypoglycemic reactions and hospitalizations in the past year and for any differences between those receiving insulin via pump therapy versus daily injections (>or=2).

RESULTS

Subjects receiving insulin via pump had better glucose control and were on lower insulin doses. Subjects with adequate glucose control used a lower insulin dose, checked blood glucose levels more frequently, and had fathers with a higher education level. Those with inadequate control were more likely to come from a single-parent home, a lower-income family, and an ethnic minority.

CONCLUSIONS

Pump therapy for adolescents should be encouraged when appropriate. Also, certain groups of adolescents need increased supervision to manage their disease appropriately. Further research needs to explore what interventions will bring more favorable outcomes for such groups.