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11. Service use and glycaemic control of young people with type 1 diabetes transitioning from paediatric to adult care: a 5‐year study.

Author

Perry, Lin, Dunbabin, Janet, Xu, Xiaoyue, James, Steven, Lowe, Julia, Acharya, Shamasunder, and Steinbeck, Katharine S.

Subjects
TYPE 1 diabetes, HEALTH services accessibility, GLYCOSYLATED hemoglobin, MEDICAL care, GLYCEMIC control, SCIENTIFIC observation, DESCRIPTIVE statistics, LONGITUDINAL method, TRANSITION to adulthood, PREDICTIVE validity
Abstract

Background: Regular contact with specialist care has been linked to better diabetes outcomes for young people with type 1 diabetes (YPwT1D), but evidence is limited to population‐based service usage and outcomes. Aims: This observational 5‐year study sought to capture YPwT1D living in the study catchment area (covering metropolitan, regional and rural Australia) as they transitioned to adult‐based diabetes healthcare services and to describe their glycaemic control and complication rates, service usage and associated factors. Methods: Records between 2010 and 2014 in a public healthcare specialist diabetes database were extracted, care processes and outcomes were described, and associations were sought between episodes of care (EOC) and potentially predictive variables. Results: Annual cohort numbers increased yearly, but without significant differences in demographic characteristics. Each year around 40% had no reported planned specialist care, and the average number of planned EOC decreased significantly year on year. Overall, mean HbA1c levels also reduced significantly, but with higher values recorded for those living in non‐metropolitan than metropolitan areas (achieving significance in 3 out of 5 years). Diabetes complication assessments were only reported in 37–46%, indicating one in five with retinopathy and hypertension affecting one in three to five young people. Conclusions: Findings highlight the importance of investment to address the specific needs of adolescents and young adults and demonstrate the need for better support during these vulnerable early years, particularly for non‐metropolitan residents. This will entail changes to funding mechanisms, the health workforce and infrastructure, and new models of care to provide equity of access and quality of specialist care. [ABSTRACT FROM AUTHOR]

Published
2024
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22. Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial

Author

Grisoni, Jeannie, Byrne, Carolyn, Davenport, Katy, Neoh, Sandra, Gougeon, Claire, Oldford, Carolyn, Young, Catherine, Green, Louisa, Rossi, Benedetta, Rogers, Helen, Cleave, Barbara, Strom, Michelle, Adelantado, Juan María, Isabel Chico, Ana, Tundidor, Diana, Malcolm, Janine, Henry, Kathy, Morris, Damian, Rayman, Gerry, Fowler, Duncan, Mitchell, Susan, Rosier, Josephine, Temple, Rosemary, Turner, Jeremy, Canciani, Gioia, Hewapathirana, Niranjala, Piper, Leanne, Kudirka, Anne, Watson, Margaret, Bonomo, Matteo, Pintaudi, Basilio, Bertuzzi, Federico, Daniela, Giuseppina, Mion, Elena, Lowe, Julia, Halperin, Ilana, Rogowsky, Anna, Adib, Sapida, Lindsay, Robert, Carty, David, Crawford, Isobel, Mackenzie, Fiona, McSorley, Therese, Booth, John, McInnes, Natalia, Smith, Ada, Stanton, Irene, Tazzeo, Tracy, Weisnagel, John, Mansell, Peter, Jones, Nia, Babington, Gayna, Spick, Dawn, MacDougall, Malcolm, Chilton, Sharon, Cutts, Terri, Perkins, Michelle, Scott, Eleanor, Endersby, Del, Dover, Anna, Dougherty, Frances, Johnston, Susan, Heller, Simon, Novodorsky, Peter, Hudson, Sue, Nisbet, Chloe, Ransom, Thomas, Coolen, Jill, Baxendale, Darlene, Holt, Richard, Forbes, Jane, Martin, Nicki, Walbridge, Fiona, Dunne, Fidelma, Conway, Sharon, Egan, Aoife, Kirwin, Collette, Maresh, Michael, Kearney, Gretta, Morris, Juliet, Quinn, Susan, Bilous, Rudy, Mukhtar, Rasha, Godbout, Ariane, Daigle, Sylvie, Lubina, Alexandra, Jackson, Margaret, Paul, Emma, Taylor, Julie, Houlden, Robyn, Breen, Adriana, Banerjee, Anita, Brackenridge, Anna, Briley, Annette, Reid, Anna, Singh, Claire, Newstead-Angel, Jill, Baxter, Janet, Philip, Sam, Chlost, Martyna, Murray, Lynne, Castorino, Kristin, Frase, Donna, Lou, Olivia, Pragnell, Marlon, Feig, Denice S, Donovan, Lois E, Corcoy, Rosa, Murphy, Kellie E, Amiel, Stephanie A, Hunt, Katharine F, Asztalos, Elizabeth, Barrett, Jon F R, Sanchez, J Johanna, de Leiva, Alberto, Hod, Moshe, Jovanovic, Lois, Keely, Erin, McManus, Ruth, Hutton, Eileen K, Meek, Claire L, Stewart, Zoe A, Wysocki, Tim, O'Brien, Robert, Ruedy, Katrina, Kollman, Craig, Tomlinson, George, and Murphy, Helen R

Published
2017
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33. Suboptimal glycemic control in adolescents and young adults with type 1 diabetes from 2011 to 2020 across Australia and New Zealand: Data from the Australasian Diabetes Data Network registry.

Author

James, Steven, Perry, Lin, Lowe, Julia, Harris, Margaret, Craig, Maria E., Anderson, Kym, Andrikopoulos, Sof, Ambler, Geoff, Barrett, Helen, Batch, Jenny, Bergman, Philip, Cameron, Fergus, Colman, Peter, Conwell, Louise, Cotterill, Andrew, Cooper, Chris, Couper, Jennifer, Davis, Elizabeth, de Bock, Martin, and Donaghue, Kim

Subjects
AUSTRALASIANS, GLYCEMIC control, TYPE 1 diabetes, ACQUISITION of data, MEDICAL records, LONGITUDINAL method
Abstract

Background: Competing challenges in adolescence and young adulthood can distract from optimal type 1 diabetes (T1D) self‐management, and increase risks of premature morbidity and mortality. There are limited data mapping the glycemic control of people with T1D in this age group, across Australasia. Research Design and Methods: Clinical data were extracted from the Australasian Diabetes Data Network, a prospective clinical diabetes registry. Inclusion criteria were individuals with T1D aged 16–25 years at their last recorded T1D healthcare visit (from 1st January 2011 to 31st December 2020), with T1D duration of at least 1 year. Data were stratified by two last recorded T1D healthcare visit ranges, while generalized estimated equation (GEE) modeling was used to examine factors associated with HbA1c across visits during the 10 year period. Results: Data from 6329 young people (52.6% male) attending 24 diabetes centers across Australasia were included. At the last visit within the most recent 5 years, mean ± SD age was 18.5 ± 2.3 years, T1D duration was 8.8 ± 4.7 years and HbA1c was 8.8 ± 1.8% (72.2 ± 19.9 mmol/mol); only 12.3% had an HbA1c below the international target of <7.0% (53 mmol/mol). Across all T1D healthcare visits, in GEE modeling, higher HbA1c was associated with female sex (B = 0.20; 95% CI 0.12 to 0.29, p < 0.001), longer T1D duration (B = 0.04, 0.03 to 0.05, p < 0.001). Lower HbA1c was associated with attendance at a pediatric T1D healthcare setting (B = −0.33, −0.45 to −0.21, p < 0.001) and use of CSII versus BD/MDI therapy (B = −0.49, −0.59 to 0.40, p < 0.001). Conclusions: This Australasian study demonstrates widespread and persistent sub‐optimal glycemic control in young people with T1D, highlighting the urgent need to better understand how healthcare services can support improved glycemic control in this population. [ABSTRACT FROM AUTHOR]

Published
2022
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34. Comparing IADPSG and NICE Diagnostic Criteria for GDM in Predicting Adverse Pregnancy Outcomes.

Author

He, Yuanying, Ching Wan Ma, Ronald, McIntyre, H. David, Sacks, David A., Lowe, Julia, Catalano, Patrick M., Tam, Wing Hung, and Ma, Ronald Ching Wan

Subjects
HYPERTENSION in pregnancy, OBESITY, NEONATAL diseases, RETROSPECTIVE studies, PREGNANCY outcomes, GESTATIONAL diabetes, CESAREAN section, GLUCOSE tolerance tests
Abstract

Objective: To compare the performance of diagnostic criteria for gestational diabetes mellitus (GDM) proposed by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) with those endorsed by the National Institute for Health and Care Excellence (NICE) in predicting adverse pregnancy outcomes.Research Design and Methods: We performed a secondary data analysis of the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study participants in five study centers. Logistic regression analyses were performed, and Akaike information criterion were applied for the comparison of different statistical prediction models. We further analyzed the performance by four racial/ethnic subgroups, namely, Whites, Hispanics, Asians, and Blacks.Results: Among all, IADPSG criteria diagnosed 267 (4.1%) more women with GDM, but predicted primary caesarean section (CS) and large for gestational age (LGA) and neonatal adiposity better than did NICE criteria after adjustment for potential confounders. Among Whites, IADPSG criteria diagnosed 65 (2.5%) more subjects with GDM and predicted LGA and neonatal adiposity better, but predicted hypertensive disorders, primary CS and clinical neonatal hypoglycemia worse. Among Hispanics, the IADPSG criteria diagnosed 203 (12.1%) more with GDM but performed better in predicting hypertensive disorders, LGA, neonatal adiposity, and hyperinsulinemia. Among Asians, the IADPSG criteria diagnosed 34 (2.0%) fewer subjects with GDM but predicted hypertensive disorders better in the unadjusted model. In Blacks, IADPSG criteria diagnosed 34 (10.5%) more women with GDM.Conclusions: IADPSG criteria appear to be more favorable than NICE for identification of adverse pregnancy outcomes among Hispanic and Asian women, while they are comparable to NICE among White women. [ABSTRACT FROM AUTHOR]

Published
2022
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