Children and adolescents with type 1 diabetes and high HbA1c - a neurodevelopmental perspective.

AIM: To examine the association between neurodevelopmental problems and high HbA1c among paediatric patients with type 1 diabetes. METHODS: A population-based study was performed among patients with type 1 diabetes (5-16 years) in two Swedish counties (n=233). The Five to Fifteen (FTF) questionnaire targeted neurodevelopmental qualities. Scores above the 90(th) percentile in the various domains are considered as definitive problems and scores above the 75(th) percentile as mild. FTF-scores were compared with regard to HbA1c ≤73 mmol/mol and >73 mmol/mol (8.0%). RESULTS: The response rate was 190 (82%). Neurodevelopmental problems were not over-represented among patients in general. Memory and learning problems were associated with HbA1c >73 mmol/mol (p = 0.01). This correlation was especially seen in adolescents (12-16 years) where mild executive problems (adjOR 3.1), definite memory problems (adjOR 5.0) and definite learning problems (adjOR 5.0) were associated with HbA1c >73 mmol/mol after adjustment for gender, diabetes duration and age of onset. CONCLUSION: Our findings that high HbA1c are more common in adolescent diabetes patients with neurodevelopmental problems generate the hypothesis that these problems might precede poor metabolic control. If so, early detection of neurodevelopmental problems would allow individually tailored treatment that may improve metabolic control and prevent complications. ©2012 The Author(s)/Acta Paediatrica ©2012 Foundation Acta Paediatrica. ©2012 The Author(s)/Acta Paediatrica ©2012 Foundation Acta Paediatrica.