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Clinical and psychological course of diabetes from adolescence to young adulthood: a longitudinal cohort study

Clinical and psychological course of diabetes from adolescence to young adulthood: a longitudinal cohort study
Clinical and psychological course of diabetes from adolescence to young adulthood: a longitudinal cohort study
OBJECTIVE—To determine the clinical and psychological course of diabetes through adolescence and the relationship with glycemic control in young adulthood.
RESEARCH DESIGN AND METHODS—A longitudinal cohort study of adolescents recruited from the register of the outpatient pediatric diabetes clinic. A total of 76 individuals (43 male patients, 33 female patients) aged 11–18 years completed baseline assessments, and 65 individuals (86%) were reinterviewed as young adults (20–28 years of age). Longitudinal assessments were made of glycemic control (HbA1c), weight gain (BMI), and development of complications. Adolescents completed self-report questionnaires to assess emotional and behavioral problems as well as self-esteem. As young adults, psychological state was assessed by the Revised Clinical Interview Schedule and the self-report Brief Symptom Inventory.
RESULTS—Mean HbA1c levels peaked in late adolescence and were worse in female participants (average 11.1% at 18–19 years of age). The proportion of individuals who were overweight (BMI >25.0 kg/m2) increased during the 8-year period from 21 to 54% in female patients and from 2 to 28% in male patients. Serious diabetes-related events included death in one patient and cognitive impairment in two patients. Individuals in whom diabetic complications developed (25% of male patients and 38% of female patients) had significantly higher mean HbA1c levels than those without complications (difference 1.9%, 95% CI 1.1–2.7, P < 0.0001). Behavioral problems at baseline were related to higher mean HbA1c during the subsequent 8 years (ß = 0.15, SEM (ß) 0.04, P < 0.001, 95% CI 0.07–0.24).
CONCLUSIONS—The outcome for this cohort was generally poor. Behavioral problems in adolescence seem to be important in influencing later glycemic control.
1935-5548
1536-1540
Bryden, Kathryn S.
72cc8e43-2c4d-475c-8f7d-4e55480fedb3
Peveler, Robert C.
93198224-78d9-4c1f-9c07-fdecfa69cf96
Stein, Alan
ba341b04-0b18-411a-9926-44182a628a1d
Neil, Andrew
a3f7f74f-af08-40cb-957c-6a7f90075e65
Mayou, Richard A.
04c867a3-634e-4412-b7f5-95bbe793e064
Dunger, David B.
5b4c17b6-7f65-424f-9d1d-17c4331a4b9c
Bryden, Kathryn S.
72cc8e43-2c4d-475c-8f7d-4e55480fedb3
Peveler, Robert C.
93198224-78d9-4c1f-9c07-fdecfa69cf96
Stein, Alan
ba341b04-0b18-411a-9926-44182a628a1d
Neil, Andrew
a3f7f74f-af08-40cb-957c-6a7f90075e65
Mayou, Richard A.
04c867a3-634e-4412-b7f5-95bbe793e064
Dunger, David B.
5b4c17b6-7f65-424f-9d1d-17c4331a4b9c

Bryden, Kathryn S., Peveler, Robert C., Stein, Alan, Neil, Andrew, Mayou, Richard A. and Dunger, David B. (2001) Clinical and psychological course of diabetes from adolescence to young adulthood: a longitudinal cohort study. Diabetes Care, 24 (9), 1536-1540. (doi:10.2337/diacare.24.9.1536).

Record type: Article

Abstract

OBJECTIVE—To determine the clinical and psychological course of diabetes through adolescence and the relationship with glycemic control in young adulthood.
RESEARCH DESIGN AND METHODS—A longitudinal cohort study of adolescents recruited from the register of the outpatient pediatric diabetes clinic. A total of 76 individuals (43 male patients, 33 female patients) aged 11–18 years completed baseline assessments, and 65 individuals (86%) were reinterviewed as young adults (20–28 years of age). Longitudinal assessments were made of glycemic control (HbA1c), weight gain (BMI), and development of complications. Adolescents completed self-report questionnaires to assess emotional and behavioral problems as well as self-esteem. As young adults, psychological state was assessed by the Revised Clinical Interview Schedule and the self-report Brief Symptom Inventory.
RESULTS—Mean HbA1c levels peaked in late adolescence and were worse in female participants (average 11.1% at 18–19 years of age). The proportion of individuals who were overweight (BMI >25.0 kg/m2) increased during the 8-year period from 21 to 54% in female patients and from 2 to 28% in male patients. Serious diabetes-related events included death in one patient and cognitive impairment in two patients. Individuals in whom diabetic complications developed (25% of male patients and 38% of female patients) had significantly higher mean HbA1c levels than those without complications (difference 1.9%, 95% CI 1.1–2.7, P < 0.0001). Behavioral problems at baseline were related to higher mean HbA1c during the subsequent 8 years (ß = 0.15, SEM (ß) 0.04, P < 0.001, 95% CI 0.07–0.24).
CONCLUSIONS—The outcome for this cohort was generally poor. Behavioral problems in adolescence seem to be important in influencing later glycemic control.

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Published date: September 2001

Identifiers

Local EPrints ID: 27540
URI: https://eprints.soton.ac.uk/id/eprint/27540
ISSN: 1935-5548
PURE UUID: 7fc03e3c-4cd7-467c-8ec5-785d841249de
ORCID for Robert C. Peveler: ORCID iD orcid.org/0000-0001-5596-9394

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Date deposited: 28 Apr 2006
Last modified: 07 Aug 2019 00:53

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