Newest Diabetes-Related Technologies for Pediatric Type 1 Diabetes and Its Impact on Routine Care: a Narrative Synthesis of the Literature

Objective: As diabetes technology use in youth increases worldwide, inequalities in access may exacerbate disparities in hemoglobin A1c (HbA1c). We hypothesized an increasing gap in diabetes technology use by socioeconomic status (SES) would be associated with increased HbA1c disparities. Research Design and Methods: Participants aged <18 years with diabetes duration ≥1 year in the Type 1 Diabetes Exchange (T1DX, US, n=16,457) and Diabetes Prospective Follow-up (DPV, Germany, n=39,836) registries were categorized into lowest (Q1) to highest (Q5) SES quintiles. Multiple regression analyses compared the relationship of SES quintiles with diabetes technology use and HbA1c from 2010-2012 and 2016-2018. Results: HbA1c was higher in participants with lower SES (in 2010-2012 & 2016-2018, respectively: 8.0% & 7.8% in Q1 and 7.6% & 7.5% in Q5 for DPV; and 9.0% & 9.3% in Q1 and 7.8% & 8.0% in Q5 for T1DX). For DPV, the association between SES and HbA1c did not change between the two time periods, whereas for T1DX, disparities in HbA1c by SES increased significantly (p<0.001). After adjusting for technology use, results for DPV did not change whereas the increase in T1DX was no longer significant. Conclusions: Although causal conclusions cannot be drawn, diabetes technology use is lowest and HbA1c is highest in those of the lowest SES quintile in the T1DX and this difference for HbA1c broadened in the last decade. Associations of SES with technology use and HbA1c were weaker in the DPV registry.

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Pediatric Type 1 Diabetes and Neurocognitive Complications Cohort Study

Case Medical Research ◽

10.31525/ct1-nct04135365 ◽

2019 ◽

Author(s):

Keyword(s):

Type 1 Diabetes ◽

Cohort Study ◽

Pediatric Type 1 Diabetes

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Nontraditional Cardiovascular Risk Factors in Pediatric Type 1 Diabetes

Current Diabetes Reviews ◽

10.2174/1573399812666161201205322 ◽

2017 ◽

Vol 13 (6) ◽

Cited By ~ 2

Author(s):

Robert P. Hoffman

Keyword(s):

Risk Factors ◽

Type 1 Diabetes ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Pediatric Type 1 Diabetes

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Coeliac disease is associated with depression in children and young adults with type 1 diabetes: results from a multicentre diabetes registry

Acta Diabetologica ◽

10.1007/s00592-020-01649-8 ◽

2021 ◽

Author(s):

Sascha René Tittel ◽

◽

Désirée Dunstheimer ◽

Dörte Hilgard ◽

Burkhild Knauth ◽

...

Keyword(s):

Type 1 Diabetes ◽

Young Adults ◽

Coeliac Disease ◽

Diabetes Patient ◽

Routine Care ◽

Diabetes Registry ◽

Increased Risk ◽

Treatment Data ◽

Children And Young Adults

Abstract Aims To analyse the association between coeliac disease (CD) and depression in children, adolescents, and young adults with type 1 diabetes (T1D). Methods We included 79,067 T1D patients aged 6–20 years, with at least six months of diabetes duration, and treatment data between 1995 and 2019 were documented in the diabetes patient follow-up registry. We categorized patients into four groups: T1D only (n = 73,699), T1 + CD (n = 3379), T1D + depression (n = 1877), or T1D + CD + depression (n = 112). Results CD and depression were significantly associated (adjusted OR: 1.25 [1.03–1.53]). Females were more frequent in both the depression and the CD group compared with the T1D only group. Insulin pumps were used more frequently in T1D + CD and T1D + depression compared with T1D only (both p < .001). HbA1c was higher in T1D + depression (9.0% [8.9–9.0]), T1D + CD + depression (8.9% [8.6–9.2]), both compared with T1D only (8.2% [8.2–8.2], all p < .001). We found comorbid autism, attention deficit hyperactivity disorder, anxiety, schizophrenia, and eating disorders more frequently in the T1D + CD + depression group compared with T1D only (all p < .001). Conclusions CD and depression are associated in young T1D patients. The double load of T1D and CD may lead to an increased risk for depression. Depression was associated with additional psychological and neurological comorbidities. Aside from imperative CD screening after T1D diagnosis and regular intervals, depression screening might be helpful in routine care, especially in patients with diagnosed CD.

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