A Comparison of ADRR Scores in Very Young, School-age, and Adolescent Children with Type 1 Diabetes Mellitus
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Abstract
Glycemic variability (GV) in children is remarkably dissimilar to GV in adults, and furthermore is unique to age-specific pediatric groups. The Average Daily Risk Range score has been shown to be a good indicator of GV in adults and some children; however, there are no data examining youths' ADRR scores based on their age, gender, or socioeconomic status (SES). The purposes of this study are to explore ADRR scores by pediatric age group: age 1-5.99 years (Group 1), 6- 11.99 years (Group 2), and 12-17.99 (Group 3), and examine the effect of SES and age on ADRR scores. One hundred and sixteen children were recruited. Glucose data and patient demographics were abstracted from medical records, and SES evaluated using the Hollinghead Four Factor measure. Mean ADRR scores (± SD) were calculated using self-monitoring blood glucose data. Data were analyzed using descriptive statistics, ANOVA and multiple linear regression. At the time of analysis, 9, 31, and 39 patients were enrolled in group 1, 2, and 3, respectively. To account for decreased enrollment in group 1 and to provide a fuller dataset for comparison, an external de-identified dataset containing comparable data on 37 subjects under the age of 6 was included in the analysis, increasing the size of group 1 to N = 46. Preliminary results suggests a decreasing, albeit nonsignificant (p=0.212), trend in ADRR scores as a function of increasing age group with means (SD) of 47 (13), 46 (11), 43 (12), respectively. Subgroup analysis of age groups and statuses suggested an interaction effect between age group and SES. Subsequently, regression analysis with age group, SES and their interaction resulted in statistically significant main effects for age (p=0.01), SES (p=0.001) and their interaction (p=0.04). These results extend the evidence for characterizing risk of glycemic variability in youths and suggest youths' ADRR scores may vary based on youths' age and SES. Further research is needed to confirm results as well as determine if ADRR risk categories are associated with health outcomes of glycemic risk in children
Table of Contents
Introduction -- Review of literature -- Methodology -- Results -- Discussion -- Appendix 1. Informed consent document -- Appendix 2. Study forms
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M.S.