Children and adolescents with type 1 diabetes and high HbA1c – a neurodevelopmental perspective
Article first published online: 19 JAN 2013
©2012 The Author(s)/Acta Pædiatrica ©2012 Foundation Acta Pædiatrica
Volume 102, Issue 4, pages 410–415, April 2013
How to Cite
Nylander, C., Toivonen, H., Nasic, S., Söderström, U., Tindberg, Y. and Fernell, E. (2013), Children and adolescents with type 1 diabetes and high HbA1c – a neurodevelopmental perspective. Acta Paediatrica, 102: 410–415. doi: 10.1111/apa.12128
- Issue published online: 18 MAR 2013
- Article first published online: 19 JAN 2013
- Accepted manuscript online: 21 DEC 2012 10:45AM EST
- Manuscript Accepted: 7 DEC 2012
- Manuscript Revised: 20 NOV 2012
- Manuscript Received: 11 JUN 2012
- The Swedish Child Diabetes Foundation
- Centre for Research and Development
- Child and adolescent;
- ‘Five to Fifteen’ questionnaire;
- Neurodevelopmental problems;
- Type 1 Diabetes Mellitus
To examine the association between neurodevelopmental problems and high HbA1c among paediatric patients with type 1 diabetes.
A population-based study was performed among patients with type 1 diabetes (5–16 years) in two Swedish counties (n = 233). The Five to Fifteen (FTF) questionnaire targeted neurodevelopmental qualities. Scores above the 90th percentile in the various domains are considered as definitive problems and scores above the 75th percentile as mild. FTF scores were compared with regard to HbA1c ≤73 mmol/mol and >73 mmol/mol (8.0%).
The response rate was 190 (82%). Neurodevelopmental problems were not overrepresented among patients in general. Memory and learning problems were associated with HbA1c >73 mmol/mol (p = 0.01). This correlation was especially seen in adolescents (12–16 years) where mild executive problems (adjOR 3.1), definite memory problems (adjOR 5.0) and definite learning problems (adjOR 5.0) were associated with HbA1c >73 mmol/mol after adjustment for gender, diabetes duration and age of onset.
Our findings that high HbA1c is more common in adolescent diabetes patients with neurodevelopmental problems generate the hypothesis that these problems might precede poor metabolic control. If so, early detection of neurodevelopmental problems would allow individually tailored treatment that may improve metabolic control and prevent complications.