Trajectory of Glycemic Control from Late Adolescence to Young Adulthood with Type 1 Diabetes: A Longitudinal Study
Authors' conclusion
Although glycemic control improved with age, a substantial proportion of adolescents and young adults with T1D failed to meet HbA1c targets. Given that CGM use was a key factor associated with better control, increasing CGM uptake alongside tailored support may improve outcomes during the transition to adulthood.
Study context
- Population
- Korean youth with T1D diagnosed before age 14 years, HbA1c at ≥3 distinct ages between 15 and 22 years, Seoul National University Children's Hospital, 1999–2024
- Participants
- 354 participants
- Outcome
- Longitudinal HbA1c trajectory
- Follow-up
- Age 15 to 22 years
Methodological detailssingle-centre, linear mixed-effects models
- Single-centre
- Linear mixed-effects models
Main finding
As reported in the abstract
Mean HbA1c at age 15 years
9.0%
75 mmol/mol
Mean HbA1c at age 22 years
8.2%
66 mmol/mol
Change in HbA1c per year
−0.103% [−1.1 mmol/mol] per year
p < 0.001
Observational data: associations, not effects.
Further findings
- Continuous glucose monitoring (CGM) use at age 22 years, by cohort — 2016-2024 cohort
- 25.2%
Factors independently associated with lower HbA1c over time · age 15 to 22 years
- Older age, male sex, CGM use and parental college education independently associated with lower HbA1c over time
- all p < 0.05
- Linear mixed-effects models
CGM use at age 22 years, by cohort
- No CGM users in the 2006-2015 cohort
HbA1c target attainment at age 22 years
- Achieved HbA1c <7% (53 mmol/mol)
- 19.6%
- Remained at HbA1c ≥9%
- 24.8%
HbA1c at age 22 years among those with HbA1c ≥9% at age 15 years
- Remained ≥9%
- nearly half
- Improved to <7%
- approximately one-tenth
Original publication
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