This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kaufman, F. R.
Right arrow Articles by Carpenter, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kaufman, F. R.
Right arrow Articles by Carpenter, S.
Related Collections
Right arrow Endocrinology
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

PEDIATRICS Vol. 103 No. 5 May 1999, pp. 948-951

Association Between Diabetes Control and Visits to a Multidisciplinary Pediatric Diabetes Clinic

Received Mar 12, 1998; accepted Nov 30, 1998.

Francine Ratner Kaufman, Mary Halvorson, and Sue Carpenter

From the Department of Pediatrics, University of Southern California School of Medicine and the Childrens Hospital Los Angeles, Los Angeles, California.

Objective.  To determine if there is a relationship between diabetes outcome as measured by HbA1C and the number of multidisciplinary clinic visits per year in children and youth with diabetes.

Research Design and Methods.  The number of clinic visits per year, the mean HbA1C (by DCA 2000, Miles, Tarrytown, NY), type of insurance, parental marital status, parental age, maximal parental grade level achieved, family income, self-identified race, and scores on adherence and knowledge tests were compared for 1995 in 360 patients with a mean age of 11.6 ± 4.8 years (1-2 visits, 85 patients; 3-4 visits, 275 patients), for 1996 in 412 patients with a mean age of 11.6 ± 4.7 years (1-2 visits, 115 patients; 3-4 visits, 297 patients), and for 1997 in 442 patients with a mean age of 11.8 ± 4.9 years (1-2 visits, 126 patients; 3-4 visits, 332 patients).

Results.  There was a significant difference in the mean HbA1C levels between subjects with 1 to 2 visits versus 3 to 4 visits during the 3 years of this study. In 1995, the mean HbA1C was 9.0 ± 2.0% for subjects with 1 to 2 visits and 8.3 ± 1.6% for subjects with 3 to 4 visits. In 1996, the mean HbA1C was 9.3 ± 2.0% for subjects with 1 to 2 visits and 8.4 ± 1.6% in those with 3 to 4 visits, whereas in 1997, the mean HbA1C was 9.1 ± 1.9% with 1 to 2 visits and 8.3 ± 1.5% with 3 to 4 visits. There was a significant difference in the number of visits by the age of the subject. The mean age of patients with 1 to 2 visits was 13.6 ± 4.5 years; it was 10.8 ± 4.6 years with 3 to 4 visits. However, for age groups <13 years versus >= 13 years, there was still a difference between HbA1C levels for subjects with 1 to 2 visits compared with 3 to 4 visits (8.9 ± 1.7% versus 8.1 ± 1.3%, respectively). The only patient/family characteristic that had an association with number of visits was the marital status of the parents. Children from single-parent households had fewer visits. There was no association between health insurance status and number of visits and there was no difference between the number of visits and the mean scores on tests of adherence or knowledge. Multivariate analysis showed that the number of visits was a significant predictor of HbA1C even after controlling for age, duration of diabetes, and scores on adherence and knowledge tests.

Conclusions.  The finding that subjects with more frequent visits to a multidisciplinary diabetes clinic had lower HbA1C levels during the 3 years of this study suggests that strategies should be developed to promote adherence with quarterly visits, particularly targeted to children from single-parent households and to teens.  Key words:  clinic visits, HbA1C, adherence, diabetes outcome.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Nephrol Dial TransplantHome page
A. Levin, M. R. Chaudhry, O. Djurdjev, M. Beaulieu, and P. Komenda
Diabetes, kidney disease and cardiovascular disease patients. Assessing care of complex patients using outpatient testing and visits: additional metrics by which to evaluate health care system functioning
Nephrol. Dial. Transplant., September 1, 2009; 24(9): 2714 - 2720.
[Abstract] [Full Text] [PDF]

Home page
 J Pediatr PsycholHome page
L. Greening, L. Stoppelbein, C. Konishi, S. S. Jordan, and G. Moll
Child Routines and Youths' Adherence to Treatment for Type 1 Diabetes
J. Pediatr. Psychol., May 1, 2007; 32(4): 437 - 447.
[Abstract] [Full Text] [PDF]

Home page
 J Pediatr PsycholHome page
D. A. Ellis, J. Yopp, T. Templin, S. Naar-King, M. A. Frey, P. B. Cunningham, A. Idalski, and L. N. Niec
Family Mediators and Moderators of Treatment Outcomes Among Youths with Poorly Controlled Type 1 Diabetes: Results From a Randomized Controlled Trial
J. Pediatr. Psychol., March 1, 2007; 32(2): 194 - 205.
[Abstract] [Full Text] [PDF]

Home page
 The Diabetes EducatorHome page
A. E. Carroll and D. G. Marrero
The role of significant others in adolescent diabetes: a qualitative study.
The Diabetes Educator, March 1, 2006; 32(2): 243 - 252.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
D. A. Ellis, M. A. Frey, S. Naar-King, T. Templin, P. B. Cunningham, and N. Cakan
The Effects of Multisystemic Therapy on Diabetes Stress Among Adolescents With Chronically Poorly Controlled Type 1 Diabetes: Findings From a Randomized, Controlled Trial
Pediatrics, December 1, 2005; 116(6): e826 - e832.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
D. A. Ellis, M. A. Frey, S. Naar-King, T. Templin, P. Cunningham, and N. Cakan
Use of Multisystemic Therapy to Improve Regimen Adherence Among Adolescents With Type 1 Diabetes in Chronic Poor Metabolic Control: A randomized controlled trial
Diabetes Care, July 1, 2005; 28(7): 1604 - 1610.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes Spectr.Home page
M. Halvorson, P. Yasuda, S. Carpenter, and K. Kaiserman
Unique Challenges for Pediatric Patients With Diabetes
Diabetes Spectr, July 1, 2005; 18(3): 167 - 173.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child.Home page
C R Cardwell, C C Patterson, M Allen, D J Carson, and on behalf of the Northern Ireland Paediatric Diabe
Diabetes care provision and glycaemic control in Northern Ireland: a UK regional audit
Arch. Dis. Child., May 1, 2005; 90(5): 468 - 473.
[Abstract] [Full Text] [PDF]

Home page
 J Pediatr PsycholHome page
D. M. Cohen, M. A. Lumley, S. Naar-King, T. Partridge, and N. Cakan
Child Behavior Problems and Family Functioning as Predictors of Adherence and Glycemic Control in Economically Disadvantaged Children with Type 1 Diabetes: A Prospective Study
J. Pediatr. Psychol., April 1, 2004; 29(3): 171 - 184.
[Abstract] [Full Text] [PDF]

Home page
 Int J Qual Health CareHome page
K. B. DeSalvo, J. P. Block, P. Muntner, and W. Merrill
Predictors of variation in office visit interval assignment
Int. J. Qual. Health Care, October 1, 2003; 15(5): 399 - 405.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
B. M. Svoren, D. Butler, B.-S. Levine, B. J. Anderson, and L. M. B. Laffel
Reducing Acute Adverse Outcomes in Youths With Type 1 Diabetes: A Randomized, Controlled Trial
Pediatrics, October 1, 2003; 112(4): 914 - 922.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
C. B. Forrest, S. A. Shipman, D. Dougherty, and M. R. Miller
Outcomes Research in Pediatric Settings: Recent Trends and Future Directions
Pediatrics, January 1, 2003; 111(1): 171 - 178.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
R. H. Cobin
Subspecialist Care Improves Diabetes Outcomes
Diabetes Care, September 1, 2002; 25(9): 1654 - 1656.
[Full Text] [PDF]

Home page
 Diabetes CareHome page
T. Danne, H. B. Mortensen, P. Hougaard, H. Lynggaard, H.-J. Aanstoot, F. Chiarelli, D. Daneman, H. Dorchy, P. Garandeau, S. A. Greene, et al.
Persistent Differences Among Centers Over 3 Years in Glycemic Control and Hypoglycemia in a Study of 3,805 Children and Adolescents With Type 1 Diabetes From the Hvidore Study Group
Diabetes Care, August 1, 2001; 24(8): 1342 - 1347.
[Abstract] [Full Text] [PDF]

Home page
 Evid. Based Nurs.Home page
Other Articles Noted
Evid. Based Nurs., October 1, 1999; 2(4): 105 - 112.
[Full Text]