Glycemic control precarious during transition to young adolescence

Glycemic control in young adolescents with type 1 diabetes is more precariously affected by the frequency of glucose monitoring than in older adolescents, according to a study published in Diabetes Care.

The study followed 225 youth ages 9 to 11 with type 1 diabetes. The two-year study examined the mutual influences of glycemic control and treatment adherence on children transitioning to young adolescence.

Monitoring correlated with glycemic control

The researchers found that glycemic control worsened as the frequency of blood glucose monitoring fell. HbA1c, which measures the average amount of sugar in the blood over three months, increased from 8.2 to 8.6 percent. Meanwhile, monitoring frequency decreased from 4.9 to 4.5 checks per day.

“The magnitude of the effect of declining treatment adherence (BGMF) on glycemic control in young adolescents may be even greater than declines observed among older adolescents,” wrote the authors of the study.

Researchers are concerned about the management of type 1 diabetes during the critical transition to adolescence.

The results of the study show that blood glucose monitoring frequency (BGMF) is a powerful tool for targeted management of glycemic control among this cohort.

The research team included scientists from Cincinnati Children's Hospital Medical Center and University of Cincinnati in Ohio, Alfred I. DuPont Hospital for Children in Delaware, and University of Miami in Florida.

Type 1 diabetes risk factors

Type 1 diabetes in children happens when the pancreas no longer produces the insulin needed to survive. The body's own immune system attacks and destroys the insulin-producing cells in the pancreas.

While the exact cause of the disease is unknown, scientists know that genetics and a family history may increase the risk of developing type 1 diabetes.

Possible risk factors not yet proven could include exposure to certain viruses like Epstein-Barr virus, coxsackievirus, mumps or cytomegalovirus that may trigger the autoimmune destruction of the islet cells in the pancreas. Low vitamin D levels and other dietary issues are also suspected risk factors.

Symptoms of type 1 diabetes in children may develop suddenly, according to Mayo Clinic. They include increased thirst and frequent urination, extreme hunger, weight loss, fatigue, irritability or unusual behavior, and blurred vision.

Treatment for type 1 diabetes is blood glucose monitoring, insulin, healthy eating and regular exercise. As a child grows, the dosage or types of insulin may need adjustment, as will the child's meal plan.

Sources: Diabetes Care, Mayo Clinic

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