Time in range and HbA(1C) after 6 months with a multidisciplinary program for children and adolescents with diabetes mellitus, real world data from Mexico City
Por:
Ramirez-Mendoza, Fernando, Gonzalez, Jose E., Gasca, Ericka, Camacho, Minerva, Cruz, V, Maria, Caraveo, Daniela, Velazquez, Alejandro, Cruz, Zaira, Segoviano, Maria, Romano, Mariana, Diego, Manlio, Made, Ana M., De León D.C., Gay-Molina, Juan, Prada, Diddier
Publicada:
1 feb 2020
Ahead of Print:
1 oct 2019
Resumen:
Background Multidisciplinary interventions may be useful for children
and adolescents with diabetes mellitus (DM), especially in areas where
new blood glucose monitoring and control technologies are difficult to
access. Methods PAANDA, a care program for adolescents and children with
diabetes, was implemented in patients aged 0 to 18 years and 11 months.
The effect of the intervention was determined by self-blood glucose
monitoring (SBGM) and glycosylated hemoglobin (HbA(1C)) levels at start
and after 6 months. Results A total of 121 patients with DM were
evaluated, mean age of 14.27 years (SD: 4.60 years). Blood glucose
measurements in range (70-120 mg/dL pre-prandial or 70-180 mg/dL
post-prandial) increased by 20.67% before breakfast, 8.14% after
breakfast (both P-value <.001), 5.02% before lunch (P-value = .02),
8.66% after lunch (P-value <.001), 11.50% before dinner (P-value
<.001), 11.87% after dinner (P-value <.001), and 8.00% at dawn
(P-value = .001). This change was accompanied by fewer values in the
hyperglycemic category (-19.49% before breakfast, -7.73% after
breakfast, both P-value <.001) and hypoglycemia (-1.18%). HbA(1C)
levels decreased significantly 1.8% (P-value = .018). Multivariate
logistic regression analysis showed an increase in glycemic control
associated with each month after the intervention time in the PAANDA
program (P-value <.001 for all the time points evaluated) and a
significant decrease in glycemic variability. Conclusions The
multidisciplinary PAANDA intervention had a beneficial effect on
glycemic control, with an improved time in range in a population of
children and adolescents with DM.
Filiaciones:
Clinic Specialized in Diabetes Management—Public Health Services of Mexico City, Mexico City, Mexico
Technology and Information for Health, Mexico City, Mexico
Unit of Biomedical Research in Cancer, Instituto Nacional de Cancerología—Institute of Biomedical Research, Universidad Nacional Autónoma de México, Mexico City, Mexico
Department of Biomedical Informatics, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
Cruz, Maria, V , Clin Specialized Diabet Management Publ Hlth Serv, Mexico City, DF, Mexico
Technol & Informat Hlth, Mexico City, DF, Mexico
Univ Nacl Autonoma Mexico, Inst Nacl Cancerol Inst Biomed Res, Unit Biomed Res Canc, Mexico City, DF, Mexico
Univ Nacl Autonoma Mexico, Fac Med, Dept Biomed Informat, Mexico City, DF, Mexico
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