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Communication frequency between visits is associated with improved glycemic control in pediatric diabetes

  • Rohini Verma , Chrystal G. Thomas , Margaret West , Laura Prichett , Christine Glancey , Julia Tracey , Kristin M. Arcara , Sheela N. Magge and Risa M. Wolf EMAIL logo
Published/Copyright: December 14, 2020

Abstract

Objectives

Children with diabetes are advised to see their diabetes team every 3 months, with interim communication to address insulin dose adjustments. Despite increasing digital accessibility, there is limited data on whether provider–patient communication frequency is associated with glycemic control in pediatric diabetes. We assessed patterns of communication between diabetes clinic visits and whether communication frequency via electronic messaging (EM) and telephone was associated with glycemic control in pediatric diabetes.

Methods

Retrospective chart review of 267 children with type 1 (T1DM) and type 2 diabetes (T2DM) over a 1-year period (July 2018–June 2019) at an urban academic pediatric diabetes center. Association between frequency of communication (via EM and telephone) and HbA1c was analyzed using regression analysis.

Results

Of 267 participants, 224 (84%) had T1DM, 43 (16%) had T2DM, mean age 11.6 years (SD 4), mean duration of diabetes 3.5 years (SD 3.4), and mean HbA1c 73.8 ± 23 mmol/mol (8.9 ± 2.2%). Most participants (82%) communicated with their diabetes team at least once per year, with a mean number of overall communications of 10.3 ± 13.6 times. Communications were via EM (48%), phone (40%), or both (53%). Participants with more frequent communication had lower HbA1c values (p=0.007), even when controlling for age, sex, provider, and number of clinic visits per year. We determined that a threshold of three communications per year was associated with a lower HbA1c (p=0.006).

Conclusions

More frequent communication with the diabetes team between visits is associated with improved glycemic control. Initiatives to contact diabetes patients between clinic visits may impact their overall glycemic control.


Corresponding author: Risa M. Wolf, MD, Assistant Professor of Pediatrics, Department of Pediatrics, Division of Pediatric Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA, Phone: +1 410 955 6463, Fax: +1 410 500 4276, E-mail:

Acknowledgments

None.

  1. Research funding: None declared.

  2. Author contributions: R.V., M.W., C.G., and R.W designed the research study. R.V., M.W., C.G., C.T., and R.W performed the research and extracted the data. R.W. and L.P. analyzed the data. R.V, C.T., and R.W wrote the paper. R.V., C.T., M.W., L.P., C.G., J.T., K.A, S.M., and R.W. have all read and approved the final article. All authors have accepted responsibility for the entire content of this submitted article and approved submission.

  3. Competing interests: No competing interests.

  4. Informed consent: This retrospective study was IRB approved with a waiver of consent.

  5. Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors’ Institutional Review Board (xxxx) or equivalent committee. (xxx-Nr.: xx/x)

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Received: 2020-09-11
Accepted: 2020-11-05
Published Online: 2020-12-14
Published in Print: 2021-02-23

© 2020 Walter de Gruyter GmbH, Berlin/Boston

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