ESPE Abstracts

Objectives: We investigated the trajectories in hemoglobin A1C (A1C) levels among transition-aged patients (age from 15 to 22 years) with type 1 diabetes (T1D).

Methods: Among the patients diagnosed with type 1 diabetes in pediatric age between 2001 and 2013 in Seoul National University Children’s Hospital, 119 patients (54 males and 65 females) with a diagnostic age for under 14 and measurement of A1C at least once at every age were included. Patients were grouped according to potential factors; diagnostic age (61 patients of <10 years vs. 58 patients of ≥10 years), age of onset of intensive insulin therapy (84 patients of <15 years vs. 32 patients of ≥15 years), whether continuous glucose monitoring (CGM) was used for at least one year during transitional age (107 patient of non-CGM user vs. 12 patients of CGM user), and parental educational level (46 patients with highly educated parents vs. 41 patient with low educated parents). We defined parents with high level of education as cases where both parents were college graduates or higher. A1C changes from ages of 15 to 22 and factors associated with glycemic control were evaluated using repeated measured ANOVA.

Results: Median age at T1D diagnosis was 9.9 (IQR 7.3-11.5) years. Mean A1C was on the gradual decline across transitional ages (P= 0.003). Except for the age of 18, percentage of patients with A1C > 9% by the age of 15-19 were over 30%, starting to decline at the age of 20 and decreasing to 22.7% at the age of 22. There was no difference in A1C depending on sex, diagnostic age, age of onset of intensive insulin therapy, and whether CGM was used. The starting age of CGM in twelve CGM users was between 16 and 21 years, with one at 16 years, one at 17 years, one at 18 years, one at 19 years, three at 20 years, and five at 21 years. A1C was significantly lower in patients with higher parental educational level (p <0.05 at all ages except at the age 18 years).

Conclusion: Patients with T1D at the transitional age tended to gradually decrease in A1C over time. Individuals with higher parental education level were more likely to show lower A1C.