Teamwork, Targets, Technology, and Tight Control in Newly Diagnosed Type 1 Diabetes: the Pilot 4T Study

Youth with type 1 diabetes (T1D) do not meet glycated hemoglobin A1c (HbA1c) targets. This work aimed to assess HbA1c outcomes in children with new-onset T1D enrolled in the Teamwork, Targets, Technology and Tight Control (4T) Study. HbA1c levels were compared between the 4T and historical cohorts....

Full description

Saved in:
Bibliographic Details
Published in:The journal of clinical endocrinology and metabolism 2022-03, Vol.107 (4), p.998-1008
Main Authors: Prahalad, Priya, Ding, Victoria Y, Zaharieva, Dessi P, Addala, Ananta, Johari, Ramesh, Scheinker, David, Desai, Manisha, Hood, Korey, Maahs, David M
Format: Article
Language:English
Subjects:
Adolescent
Blood Glucose - analysis
Blood Glucose Self-Monitoring
Blood sugar monitoring
Child
Children
Clinical
Comparative analysis
Dextrose
Diabetes Mellitus, Type 1 - diagnosis
Diabetes therapy
Glucose
Glycated Hemoglobin A - analysis
Glycosylated hemoglobin
Health aspects
Humans
Loess
Medical equipment and supplies industry
Medical test kit industry
Technology
Type 1 diabetes
Work groups
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Youth with type 1 diabetes (T1D) do not meet glycated hemoglobin A1c (HbA1c) targets. This work aimed to assess HbA1c outcomes in children with new-onset T1D enrolled in the Teamwork, Targets, Technology and Tight Control (4T) Study. HbA1c levels were compared between the 4T and historical cohorts. HbA1c differences between cohorts were estimated using locally estimated scatter plot smoothing (LOESS). The change from nadir HbA1c (month 4) to 12 months post diagnosis was estimated by cohort using a piecewise mixed-effects regression model accounting for age at diagnosis, sex, ethnicity, and insurance type. We recruited 135 youth with newly diagnosed T1D at Stanford Children's Health. Starting July 2018, all youth within the first month of T1D diagnosis were offered continuous glucose monitoring (CGM) initiation and remote CGM data review was added in March 2019. The main outcomes measure was HbA1c. HbA1c at 6, 9, and 12 months post diagnosis was lower in the 4T cohort than in the historic cohort (-0.54% to -0.52%, and -0.58%, respectively). Within the 4T cohort, HbA1c at 6, 9, and 12 months post diagnosis was lower in those patients with remote monitoring than those without (-0.14%, -0.18% to -0.14%, respectively). Multivariable regression analysis showed that the 4T cohort experienced a significantly lower increase in HbA1c between months 4 and 12 (P 
ISSN:0021-972X
1945-7197
DOI:10.1210/clinem/dgab859