Impact of Sten-O Starter on Glycemic Management in Children and Adolescents with Type 1 Diabetes in the North Region of Denmark

Abstract

Objective

Educational material on type 1 diabetes (T1D) is limited. An educational application named Sten-O Starter has been implemented for children and adolescents with T1D and their parents; however, its effect on glycemic management is unknown. The objective was therefore to examine the clinical impact of the Sten-O Starter on glycemic management among children and adolescents with T1D.

Methods

The levels of glycated hemoglobin (HbA1c) at 0–12 months after diagnosis were compared between two cohorts (the intervention received Sten-O Starter and the control received usual care). A mixed model of repeated measurements adjusted for age, sex, and HbA1c at diagnosis was used. A subgroup analysis of the cohorts was performed in which the time in range, time above range, and time below range (TBR) were compared at 6 months and 12 months after diagnosis using the Wilcoxon rank sum test.

Results

181 children and adolescents were included and all HbA1c measurements from the time of diagnosis to 12-month follow-up: No significant difference (p = 0.35) was found in HbA1c changes between the cohorts. However, the difference in median HbA1c at the 12-month follow-up between the intervention cohort and the control cohort (50 mmol/mol vs. 54 mmol/mol) was borderline significant (p = 0.059). A subgroup analysis of 30 children and adolescents revealed that TBR was significantly different (intervention: 1.2 % vs control: 2.6 %; p = 0.02) at 6 months and at 12 months (intervention: 1 % vs control; 2 %; p = 0.05).

Conclusion

The results indicate improved glycemic management among children and adolescents with T1D after use of the Sten-O Starter.