Time in range and HbA1C after 6 months with a multidisciplinary program for children and adolescents with diabetes mellitus, real world data from Mexico City. Issue 1 (22nd October 2019)

• Record Type: Journal Article
• Authors: Ramírez‐Mendoza, Fernando; González, Jose E.; Gasca, Ericka; Camacho, Minerva; Cruz, María V.; Caraveo, Daniela; Velázquez, Alejandro; Cruz, Zaira; Segoviano, María; Romano, Mariana; Diego, Manlio; Made, Ana M.; de León, David Cantú; Gay‐Molina, Juan; Prada, Diddier
• Is Part Of: Pediatric diabetes. Volume 21:Issue 1(2020)
• Page Start: 61
• Page End: 68
• Publication Date: 2019-10-22
• Subjects: childhood and adolescent diabetes mellitus -- diabetes education program -- intervention -- multidisciplinary -- PAANDA -- SBGM -- self‐monitoring -- time in range; Diabetes in children -- Periodicals; 616.462
• DOI: 10.1111/pedi.12921
• Languages: English
• ISSNs: 1399-543X

Abstract

Abstract: 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 (HbA1C ) 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%). HbA1C 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.