PMID- 28693789
OWN - NLM
STAT- MEDLINE
DCOM- 20170911
LR  - 20221207
IS  - 1097-6833 (Electronic)
IS  - 0022-3476 (Linking)
VI  - 188
DP  - 2017 Sep
TI  - Real-Life Glycemic Control in Children with Type 2 Diabetes: A Population-Based 
      Study.
PG  - 173-180.e1
LID - S0022-3476(17)30770-9 [pii]
LID - 10.1016/j.jpeds.2017.05.074 [doi]
AB  - OBJECTIVES: To characterize children and adolescents with type 2 diabetes 
      mellitus (T2DM) insured by a large health maintenance organization, and to 
      identify variables associated with treatment quality and disease outcome. STUDY 
      DESIGN: Children and adolescents diagnosed with T2DM over a 9-year period were 
      identified from the database of Clalit Health Services, a large health 
      maintenance organization in Israel (1 213 362 members aged 0-18 years). 
      Demographic, anthropometric, clinical, and laboratory data were analyzed. 
      RESULTS: A total of 96 patients (47 males) met our inclusion criteria. The mean 
      age at diagnosis of T2DM was 14.25 +/- 2.51 years. At the time of diagnosis, the 
      median hemoglobin A1c (HbA1c) level was 7.8%, and additional components of the 
      metabolic syndrome were present in 14.9%-67.4% of the patients. At the end of the 
      follow-up period (3.11 +/- 1.75 years), >50% of the patients were being treated 
      with insulin; the median HbA1c value was 7.97%, and 44.6% of the patients 
      achieved the target HbA1c of <7.0%. On multivariate linear regression analysis, 
      the variables found to predict worse glycemic control (ie, higher HbA1c) were a 
      higher HbA1c at diagnosis, a higher body mass index SD score at diagnosis, fewer 
      annual HbA1c tests, and Arabic ethnicity [F(4,81) = 7.139; P < .001; 
      R(2) = 0.271]. CONCLUSION: This population-based study of pediatric patients with 
      T2DM demonstrates that reasonable glycemic control can be achieved in both 
      community and outpatient hospital settings. Nevertheless, there is room for 
      improvement in intervention programs to optimize outcomes and decrease the risk 
      of complications.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Meyerovitch, Joseph
AU  - Meyerovitch J
AD  - The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, 
      National Center for Childhood Diabetes, Schneider Children's Medical Center of 
      Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, 
      Tel Aviv, Israel; Medicine and Community Wings, Clalit Health Services, Tel Aviv, 
      Israel. Electronic address: josephm@post.tau.ac.il.
FAU - Zlotnik, Maya
AU  - Zlotnik M
AD  - Department of Medicine E, Chaim Sheba Medical Center, Tel Hashomer, Israel.
FAU - Yackobovitch-Gavan, Michal
AU  - Yackobovitch-Gavan M
AD  - The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, 
      National Center for Childhood Diabetes, Schneider Children's Medical Center of 
      Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, 
      Tel Aviv, Israel.
FAU - Phillip, Moshe
AU  - Phillip M
AD  - The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, 
      National Center for Childhood Diabetes, Schneider Children's Medical Center of 
      Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, 
      Tel Aviv, Israel.
FAU - Shalitin, Shlomit
AU  - Shalitin S
AD  - The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, 
      National Center for Childhood Diabetes, Schneider Children's Medical Center of 
      Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, 
      Tel Aviv, Israel.
LA  - eng
PT  - Journal Article
DEP - 20170708
PL  - United States
TA  - J Pediatr
JT  - The Journal of pediatrics
JID - 0375410
RN  - 0 (Cholesterol, HDL)
RN  - 0 (Cholesterol, LDL)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Adolescent
MH  - Arabs
MH  - Body Mass Index
MH  - Cholesterol, HDL/blood
MH  - Cholesterol, LDL/blood
MH  - Diabetes Mellitus, Type 2/*blood/drug therapy/*epidemiology
MH  - Female
MH  - Glycated Hemoglobin/*analysis
MH  - Humans
MH  - Hypertension/diagnosis/epidemiology
MH  - Hypertriglyceridemia/diagnosis/epidemiology
MH  - Hypoglycemic Agents/therapeutic use
MH  - Insulin/therapeutic use
MH  - Israel/epidemiology
MH  - Jews
MH  - Male
MH  - Metabolic Syndrome/diagnosis/epidemiology
MH  - Multivariate Analysis
MH  - Pediatric Obesity/epidemiology
MH  - Young Adult
OTO - NOTNLM
OT  - adolescents
OT  - children
OT  - glycemic control
OT  - obesity
OT  - type 2 diabetes
EDAT- 2017/07/12 06:00
MHDA- 2017/09/12 06:00
CRDT- 2017/07/12 06:00
PHST- 2016/09/21 00:00 [received]
PHST- 2017/04/17 00:00 [revised]
PHST- 2017/05/26 00:00 [accepted]
PHST- 2017/07/12 06:00 [pubmed]
PHST- 2017/09/12 06:00 [medline]
PHST- 2017/07/12 06:00 [entrez]
AID - S0022-3476(17)30770-9 [pii]
AID - 10.1016/j.jpeds.2017.05.074 [doi]
PST - ppublish
SO  - J Pediatr. 2017 Sep;188:173-180.e1. doi: 10.1016/j.jpeds.2017.05.074. Epub 2017 
      Jul 8.