A Novel Follow-Up Model for Type 1 Diabetes in Children Leads to Higher Glycemic Control.

Background: Poor glycemic control in type 1 diabetes (T1D) in children leads to a higher risk of diabetic complications. In the pediatric department at the North Denmark Regional Hospital, only one-third of all children with diabetes were well-regulated, defined as HbA_1c no more than 58 mmol/mol (7.5%), in 2016. Therefore, a novel follow-up model was developed to increase the proportion of children with well-regulated T1Ds. The aim of this study was to evaluate the effect of a standardized follow-up model for poorly regulated diabetes on mean HbA_1c. Methods: All children aged 0-18 with T1Ds were included in this study. A novel standardized follow-up model was developed if HbA_1c was greater than 58 mmol/mol (7.5%), in which children were followed more closely until improvement in glycemic control. Results: In the reference year, only one-third of children with diabetes were well-regulated and 19% were poorly regulated (HbA_1c greater than 75 mmol/mol (9.0%)). After fully implementing the model, two-thirds of the children had well-regulated diabetes, and only a few percent had poorly regulated diabetes. The mean HbA_1c decreased by almost 10 mmol/mol (or 0.8%) from the reference year to the following years when the model was fully implemented. Conclusion: This follow-up model for poorly regulated diabetes increased the fraction of children with well-regulated diabetes in our clinic and significantly decreased mean HbA_1c.