Association between Glycemic Control and Clinic Attendance in Emerging Adults with Type 1 Diabetes: A Tertiary Center Experience

Aims. The transition of emerging adults with type 1 diabetes (T1D) from pediatric diabetes clinics to adult clinics between 18 and 21 years of age could result in decreased clinic attendance and thus worsen glycemic control. Our institutional policy offering surveillance till age 30 enabled us to ev...

Full description

Saved in:
Bibliographic Details
Main Authors: Eldad Fisher, Liora Lazar, Shlomit Shalitin, Michal Yackobovitch-Gavan, Liat de Vries, Tal Oron, Ariel Tenenbaum, Moshe Phillip, Yael Lebenthal
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/2018/9572817
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832548384402046976
author Eldad Fisher
Liora Lazar
Shlomit Shalitin
Michal Yackobovitch-Gavan
Liat de Vries
Tal Oron
Ariel Tenenbaum
Moshe Phillip
Yael Lebenthal
author_facet Eldad Fisher
Liora Lazar
Shlomit Shalitin
Michal Yackobovitch-Gavan
Liat de Vries
Tal Oron
Ariel Tenenbaum
Moshe Phillip
Yael Lebenthal
author_sort Eldad Fisher
collection DOAJ
description Aims. The transition of emerging adults with type 1 diabetes (T1D) from pediatric diabetes clinics to adult clinics between 18 and 21 years of age could result in decreased clinic attendance and thus worsen glycemic control. Our institutional policy offering surveillance till age 30 enabled us to evaluate clinic attendance without the confounding effect of transition. Our aim was to determine the association between glycemic control (HbA1c) and attendance rate. Methods. The medical records of 261 (54% males) young adult T1D patients (median age 22.9 years) were reviewed. Patients were stratified according to the attainment/nonattainment of glycemic targets (HbA1c ≤ 7% versus HbA1c > 7% (53 mmol/mol)). The attendance rate was calculated as the number of clinic visits/number of scheduled appointments. Results. Median annual number of scheduled visits was 3 (3, 4); attendance rate was 75% (53.6%, 100%). Seventy-four (28.4%) patients attained glycemic targets (median HbA1c 6.5% (48 mmol/mol) (6.3%, 6.8% (45.51 mmol/mol)); 187 (71.6%) patients had a median HbA1c of 7.8% (62 mmol/mol) (7.4%, 8.4% (57.68 mmol/mol)). The attainment of the treatment target was more prevalent in older patients (P=0.006), in male patients (P=0.007), and in patients with higher education (P=0.017). Higher attendance rate (β (2.483), P<0.001) and male gender (β (0.746), P=0.015) were associated with better metabolic control. Conclusions. In emerging adults with T1D during the ongoing stable phase of diabetes management, higher attendance rate, rather than absolute number of clinic visits, was associated with the attainment of glycemic targets.
format Article
id doaj-art-24b092bc831e42e6a56ee492554e885f
institution Kabale University
issn 2314-6745
2314-6753
language English
publishDate 2018-01-01
publisher Wiley
record_format Article
series Journal of Diabetes Research
spelling doaj-art-24b092bc831e42e6a56ee492554e885f2025-02-03T06:14:08ZengWileyJournal of Diabetes Research2314-67452314-67532018-01-01201810.1155/2018/95728179572817Association between Glycemic Control and Clinic Attendance in Emerging Adults with Type 1 Diabetes: A Tertiary Center ExperienceEldad Fisher0Liora Lazar1Shlomit Shalitin2Michal Yackobovitch-Gavan3Liat de Vries4Tal Oron5Ariel Tenenbaum6Moshe Phillip7Yael Lebenthal8Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, IsraelThe Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva 49202, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, IsraelThe Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva 49202, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, IsraelAims. The transition of emerging adults with type 1 diabetes (T1D) from pediatric diabetes clinics to adult clinics between 18 and 21 years of age could result in decreased clinic attendance and thus worsen glycemic control. Our institutional policy offering surveillance till age 30 enabled us to evaluate clinic attendance without the confounding effect of transition. Our aim was to determine the association between glycemic control (HbA1c) and attendance rate. Methods. The medical records of 261 (54% males) young adult T1D patients (median age 22.9 years) were reviewed. Patients were stratified according to the attainment/nonattainment of glycemic targets (HbA1c ≤ 7% versus HbA1c > 7% (53 mmol/mol)). The attendance rate was calculated as the number of clinic visits/number of scheduled appointments. Results. Median annual number of scheduled visits was 3 (3, 4); attendance rate was 75% (53.6%, 100%). Seventy-four (28.4%) patients attained glycemic targets (median HbA1c 6.5% (48 mmol/mol) (6.3%, 6.8% (45.51 mmol/mol)); 187 (71.6%) patients had a median HbA1c of 7.8% (62 mmol/mol) (7.4%, 8.4% (57.68 mmol/mol)). The attainment of the treatment target was more prevalent in older patients (P=0.006), in male patients (P=0.007), and in patients with higher education (P=0.017). Higher attendance rate (β (2.483), P<0.001) and male gender (β (0.746), P=0.015) were associated with better metabolic control. Conclusions. In emerging adults with T1D during the ongoing stable phase of diabetes management, higher attendance rate, rather than absolute number of clinic visits, was associated with the attainment of glycemic targets.http://dx.doi.org/10.1155/2018/9572817
spellingShingle Eldad Fisher
Liora Lazar
Shlomit Shalitin
Michal Yackobovitch-Gavan
Liat de Vries
Tal Oron
Ariel Tenenbaum
Moshe Phillip
Yael Lebenthal
Association between Glycemic Control and Clinic Attendance in Emerging Adults with Type 1 Diabetes: A Tertiary Center Experience
Journal of Diabetes Research
title Association between Glycemic Control and Clinic Attendance in Emerging Adults with Type 1 Diabetes: A Tertiary Center Experience
title_full Association between Glycemic Control and Clinic Attendance in Emerging Adults with Type 1 Diabetes: A Tertiary Center Experience
title_fullStr Association between Glycemic Control and Clinic Attendance in Emerging Adults with Type 1 Diabetes: A Tertiary Center Experience
title_full_unstemmed Association between Glycemic Control and Clinic Attendance in Emerging Adults with Type 1 Diabetes: A Tertiary Center Experience
title_short Association between Glycemic Control and Clinic Attendance in Emerging Adults with Type 1 Diabetes: A Tertiary Center Experience
title_sort association between glycemic control and clinic attendance in emerging adults with type 1 diabetes a tertiary center experience
url http://dx.doi.org/10.1155/2018/9572817
work_keys_str_mv AT eldadfisher associationbetweenglycemiccontrolandclinicattendanceinemergingadultswithtype1diabetesatertiarycenterexperience
AT lioralazar associationbetweenglycemiccontrolandclinicattendanceinemergingadultswithtype1diabetesatertiarycenterexperience
AT shlomitshalitin associationbetweenglycemiccontrolandclinicattendanceinemergingadultswithtype1diabetesatertiarycenterexperience
AT michalyackobovitchgavan associationbetweenglycemiccontrolandclinicattendanceinemergingadultswithtype1diabetesatertiarycenterexperience
AT liatdevries associationbetweenglycemiccontrolandclinicattendanceinemergingadultswithtype1diabetesatertiarycenterexperience
AT taloron associationbetweenglycemiccontrolandclinicattendanceinemergingadultswithtype1diabetesatertiarycenterexperience
AT arieltenenbaum associationbetweenglycemiccontrolandclinicattendanceinemergingadultswithtype1diabetesatertiarycenterexperience
AT moshephillip associationbetweenglycemiccontrolandclinicattendanceinemergingadultswithtype1diabetesatertiarycenterexperience
AT yaellebenthal associationbetweenglycemiccontrolandclinicattendanceinemergingadultswithtype1diabetesatertiarycenterexperience