Glycemic Control in Youth with Diabetes: The SEARCH for Diabetes in Youth Study

Petitti, Diana B.; Klingensmith, Georgeanna J.; Bell, Ronny A.; Andrews, Jeanette S.; Dabelea, Dana; Imperatore, Giuseppina; Marcovina, Santica; Pihoker, Catherine; Standiford, Debra; Waitzfelder, Beth; Mayer-Davis, Elizabeth; for the SEARCH for Diabetes in Youth Study Group,

doi:10.1016/j.jpeds.2009.05.025

« Previous Next »The Journal of Pediatrics
Volume 155, Issue 5 , Pages 668-672.e3, November 2009

Glycemic Control in Youth with Diabetes: The SEARCH for Diabetes in Youth Study

Diana B. Petitti, MD, MPH
- Biomedical Informatics, Arizona State University, Phoenix AZ
Georgeanna J. Klingensmith, MD
- Pediatric Clinics, Barbara Davis Center for Childhood Diabetes, University of Colorado at Denver and Health Sciences Center, Denver, CO
Ronny A. Bell, PhD, MS
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC
- Reprint requests: Ronny Bell, PhD, PI, SEARCH Coordinating Center, Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1063.
Jeanette S. Andrews, MS
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, NC
Dana Dabelea, MD, PhD
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Denver, CO
Giuseppina Imperatore, MD, PhD
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
Santica Marcovina, PhD
- Department of Medicine, University of Washington, Seattle WA
Catherine Pihoker, MD
- Division of Endocrinology and Diabetes, Children's Hospital and Regional Medical Center, Seattle WA
Debra Standiford, MSN, CNP
- Division of Endocrinology, Children's Hospital Medical Center, Cincinnati OH
Beth Waitzfelder, PhD
- Pacific Health Research Institute, Honolulu HI
Elizabeth Mayer-Davis, PhD
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
for the SEARCH for Diabetes in Youth Study Group
- A complete list of the members of the SEARCH for Diabetes in Youth Study Group is available at www.jpeds.com (Appendix 1).

Received 3 October 2008; received in revised form 23 March 2009; accepted 19 May 2009. published online 30 July 2009.

Objective

To assess correlates of glycemic control in a diverse population of children and youth with diabetes.

Study design

This was a cross-sectional analysis of data from a 6-center US study of diabetes in youth, including 3947 individuals with type 1 diabetes (T1D) and 552 with type 2 diabetes (T2D), using hemoglobin A_1c (HbA_1c) levels to assess glycemic control.

Results

HbA_1c levels reflecting poor glycemic control (HbA_1c ≥ 9.5%) were found in 17% of youth with T1D and in 27% of those with T2D. African-American, American Indian, Hispanic, and Asian/Pacific Islander youth with T1D were significantly more likely to have higher HbA_1c levels compared with non-Hispanic white youth (with respective rates for poor glycemic control of 36%, 52%, 27%, and 26% vs 12%). Similarly poor control in these 4 racial/ethnic groups was found in youth with T2D. Longer duration of diabetes was significantly asso∗ciated with poorer glycemic control in youth with T1D and T2D.

Conclusions

The high percentage of US youth with HbA_1c levels above the target value and with poor glycemic control indicates an urgent need for effective treatment strategies to improve metabolic status in youth with diabetes.

BMI, Body mass index, HbA1c, Glycated hemoglobin, T1D, Type 1 diabetes, T2D, Type 2 diabetes