SAN FRANCISCO — Uptake of diabetes complication screening may be predicted by frequency of clinic attendance and socioeconomic status in young patients with type 1 diabetes, according to research results presented at the American Diabetes Association 79th Scientific Sessions, held June 7 to 11, 2019, in San Francisco, California.
The study included 1832 participants diagnosed with type 1 diabetes at a single center in Sydney, Australia, between 1990 and 2009, whose median age at diagnosis was 8.8 years (range, 5.5-11.6 years; 51% girls). Comparisons for body mass index, socioeconomic disadvantage, and hemoglobin A1c (HbA1c) were made between participants who attended diabetes complication screenings (67%) and those who did not (34%).
In the first 2 years after diabetes diagnosis, participants who did not undergo complication screening attended diabetes clinics 1.7 times per year compared with 2.5 times per year for patients who underwent screening (P <.001). Median HbA1c was 7.9% in patients who did not attend complication screening vs 8.0% in screening attendees (P =.03) over these 2 years, but body mass index did not differ significantly between the groups. Median lifetime HbA1c was 8.1% vs 8.3% in patients who did not and did attend diabetes complication screenings, respectively (P <.001).
Patients who underwent complication screening had a mean of 9.1 years in the Diabetes Service compared with 3.8 years in patients who did not have screening performed (P <.001). In the patients who did not undergo screening, 40% were considered socioeconomically disadvantaged compared with 23% of the group that had complication screenings (P <.001). Multivariable analysis revealed that those who attended complication screenings had more visits to clinics within the first 2 years after diagnosis, had higher median lifetime HbA1c, and had less socioeconomic disadvantage.
The study researchers concluded that “[socioeconomic disadvantage] and less frequent clinic attendance in the first 2 years after diagnosis but not obesity, were predictors of non-uptake of complication screening and are likely to influence the outcome of [type 1 diabetes] for these patients. It remains unclear if the non-attenders had medical follow up at other services.”
Aulich J, Chan AK, Cusumano J, et al. Predictors of diabetes complication screening at two years from diagnosis in an incident cohort. Presented at: American Diabetes Association 79th Scientific Sessions; June 7-11, 2019; San Francisco, CA. Poster 186-LB.