Comparable glycemic outcomes for pediatric type 1 diabetes patients in metropolitan and non‐metropolitan regions of Western Australia: A population‐based study. Issue 3 (30th June 2017)

• Record Type: Journal Article
• Authors: Joshi, Kiranjit K; Haynes, Aveni; Smith, Grant; Jones, Timothy W; Davis, Elizabeth A
• Is Part Of: Pediatric diabetes. Volume 19:Issue 3(2018)
• Page Start: 486
• Page End: 492
• Publication Date: 2017-06-30
• Subjects: centralized service -- children -- glycemic outcome -- region -- type 1 diabetes; Diabetes in children -- Periodicals; 616.462
• DOI: 10.1111/pedi.12550
• Languages: English
• ISSNs: 1399-543X

Abstract

Abstract : Background: Pediatric patients diagnosed with type 1 diabetes (T1D) in Western Australia (WA) are managed by a single, specialist multidisciplinary diabetes service based at a central tertiary hospital in the capital city, Perth, which provides outreach care in regional centers. Objective: To investigate the hypothesis that outcomes for a contemporary, population‐based pediatric T1D cohort, managed by a single tertiary service are similar for metropolitan and non‐metropolitan patients using this model of care. To confirm that the cohort is indeed population based, a secondary aim of the study was to determine the case ascertainment of the Western Australian Children's Diabetes Database (WACDD). Methods: Data for all T1D patients aged <18 years, who attended the diabetes clinics (metropolitan and non‐metropolitan), at least once in 2014, were extracted from the WACDD and outcomes including HbA1c and severe hypoglycemia (SH) rates analyzed. Results: In 2014, a total of 1017 patients (492 females, 525 males) attended the diabetes clinics (54% metropolitan and 46% non‐metropolitan). After adjusting for age, sex, diabetes duration, and insulin regimen, region of clinic was not a significant predictor of mean HbA1c or SH rate. The case ascertainment of the WACDD was estimated to be 99.9% complete for children diagnosed with T1D aged <15 years between 2002 and 2012. Conclusions: This study reports similar glycemic outcomes for patients attending diabetes clinics in metropolitan and non‐metropolitan areas of WA, suggesting that a model of care provided as outreach from a specialized diabetes service is effective in achieving equitable glycemic outcomes.