Intensive diabetes management in adolescents with type 1 diabetes: The importance of intensive follow-up

Minimal information exists on the education and follow-up required to successfully initiate intensive diabetes management (IDM) in adolescents with type 1 diabetes. We performed a retrospective analysis of HbA(1c) 3 and 15 months after initiation of IDM in two cohorts: (1) 17 patients who received individualised education in IDM and intensive early follow-up, and (2) 11 patients who participated in group education for initiation of IDM with standard follow-up. Entry HbA(1c) was higher in the individualised education patients (9.54±0.3% [mean±SE] versus 8.2±0.4%, p=0.02). After 3 months of IDM, HbA(1c) improved in both cohorts reaching similar levels (individualised: 7.0±0.1%, p<0.0001 vs entry; group: 7.3±0.2%, p=0.05). During the following year, with routine follow-up for both cohorts, HbA(1c) levels rose approximately 1% as patients reverted to a multiple daily injection regimen. Irrespective of the educational approach, we believe maintenance of IDM and optimal HbA(1c) requires long-term intensive follow- up.