Predictors of Insulin Regimens and Impact on Outcomes in Youth with Type 1 Diabetes: The SEARCH for Diabetes in Youth Study - 07/08/11
, Giuseppina Imperatore, MD, PhD b, Georgeanna Klingensmith, MD c, Diana Petitti, MD, MPH d, Beatriz Rodriguez, MD, MPH, PhD e, Andrea M. Anderson, MS f, I. David Schwartz, MD g, Debra A. Standiford, RN, MSN, CNP h, Catherine Pihoker, MD a
Reprint requests: Carolyn A. Paris, MD, MPH, Children’s Hospital & Regional Medical Center, 4800 Sand Point Way NE, B-5518, Seattle, Washington 98105-0371.Abstract |
Objectives |
To describe the insulin regimens used to treat type 1 diabetes mellitus (T1DM) in youth in the United States, to explore factors related to insulin regimen, and to describe the associations between insulin regimen and clinical outcomes, particularly glycemic control.
Study design |
A total of 2743 subjects participated in the SEARCH for Diabetes in Youth study, an observational population-based study of youth diagnosed with T1DM, conducted at 6 centers. Data collected during a study visit included clinical and sociodemographic information, body mass index, laboratory measures, and insulin regimen.
Results |
Sociodemographic characteristics were associated with insulin regimen. Insulin pump therapy was more frequently used by older youth, females, non-Hispanic whites, and families with higher income and education (P = .02 for females, P < .001 for others). Insulin pump use was associated with the lowest hemoglobin A1C levels in all age groups. A1C levels were >7.5% in >70% of adolescents, regardless of regimen.
Conclusions |
Youth using insulin pumps had the lowest A1C; A1C was unacceptably high in adolescents. There is a need to more fully assess and understand factors associated with insulin regimens recommended by providers and the influence of race/ethnicity, education, and socioeconomic status on these treatment recommendations and to develop more effective treatment strategies, particularly for adolescents.
Le texte complet de cet article est disponible en PDF.Mots-clés : ADA, DCCT, DM, FCP, MDI, T1DM
Plan
Vol 155 - N° 2
P. 183 - août 2009 Retour au numéro
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