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According to the results of a new study, a significant number of children and young adults with diabetes may not be getting the routine tests recommended for managing the disease.…
Researchers found that of more than 1,500 young people with either type 1 or type 2 diabetes, about one-third had not undergone eye exams or had tests of long-term blood sugar control as recommended by the American Diabetes Association (ADA).
According to ADA guidelines — the main ones doctors follow for managing diabetes — children and young adults with the disease should have a hemoglobin A1C test at least twice a year (or three times if they are on insulin). In this study 32 percent of kids were not getting the test as often as recommended by the ADA.
A similar number, 34 percent, were not getting eye exams as recommended; the ADA says those should be done once a year in everyone with type 2 diabetes, and in anyone who has had type 1 diabetes for at least five years and is at least 10 years old.
It’s not clear why some young people were not getting all the suggested tests. But the research offers some clues. In general, older teenagers and young adults were less likely than younger kids to be compliant. That may be because they’re not as vigilant with their diabetes care as their parents were. Or it could be lack of insurance, or a change in doctors.
Children from low-income families were also less likely to get all the recommended tests. Those whose families made upwards of $75,000 a year were about 65 percent more likely to have had the tests as those whose families made less than $25,000. That was with insurance coverage taken into account. Even among individuals with diabetes who have insurance, co-payments for healthcare services, medications and diabetes supplies can be difficult for some families to manage. The results are based on surveys of 1,514 U.S. children, teenagers and young adults and 85% had type 1 diabetes.
The group was doing fairly well when it came to certain ADA-recommended tests. Nearly all — 95 percent — got regular blood pressure checks, while 88 percent had had their cholesterol checked at least once (or once a year if they were 18 or older).
When it came to tests of kidney function, 83 percent were getting them as often as the ADA recommends. Diabetes can eventually lead to kidney disease, so yearly urine tests are suggested — starting at age 10 for children who’ve had type 1 diabetes for at least five years.
In this study, children and young adults who were seeing an endocrinologist were more likely to have received all the recommended tests compared with their counterparts seeing a general practitioner.
Pediatrics, online August 22, 2011
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