Endocrine Abstracts

Objective: To test the hypothesis that poor adolescent diabetic control results in poor adult control.

Methods: We conducted a retrospective case notes study involving 57 patients (M:F 30:27) in a teaching hospital. Patients who had diabetes atleast for a minimum period of 10 years were selected and their HbA1c when they were between 17 and 19 years of age were compared with the most recent HbA1c.

The adolescent control was divided into 3 groups: Group 1 with moderate control-HbA1c <8.5%, Group 2 with poor control-HbA1c between 8.6 to 10%, Group 3 with worst control-HbA1c >10%.

Results: The mean duration of diabetes was 16.9±4.9 years. Median age was 31 years. Mean adolescent control was 10.71±2.03 and mean adult control was 8.9±1.5%. Although 96 patients were initially selected 39 patients were eliminated due to lack of HbA1c as this became widely available only in mid 80s. The following changes were noted between the groups: Group 1: HbA1c from 7.67±0.21 worsened to 8.17±1.1 (P−0.455), Group 2: HbA1c from 9.28±0.47 improved to 8.58±1.7 (P−0.09), Group 3: HbA1c from 11.98±1.62 improved to 9.04±1.40 (P−<0.01).

Conclusion: Patients with moderate control worsened marginally and those with poor control improved marginally (non-significant). Patients in group 3 with worst control remained as the worst group even as adults although the overall control improved significantly. It is likely that the improvement in patient education, multiple injections regimen, intervention by health professionals and diabetic specialist nurses addressing various risk factors including psychosocial aspects would have had a positive impact in this group.

Patients with the better control as adolescence remained better controlled as adults and hence efforts must be made to improve HbA1c in the adolescent age group.