Adherence in Diabetes Questionnaire (ADQ) score as predictor of 11-year HbA1c trajectories in children and adolescents with type 1 diabetes: A population-based longitudinal study

Aims: To identify 11-year HbA1c trajectories in children/adolescents with type 1 diabetes and determine whether baseline caregiver-and/or child/adolescent-reported Adherence in Diabetes Questionnaire (ADQ) scores and multiple covariates predict HbA1c trajectory membership.Methods: For a 2009 population-based cohort of children/adolescents with type 1 diabetes, we analyzed HbA1c follow-up (2010-2020) data from Danish diabetes registries. HbA1c trajectories were identified with group-based trajectory modeling. Using multinomial logistic regression, we tested whether ADQ scores predicted tra-jectory membership when adjusting for sex, age at diabetes diagnosis, diabetes duration, family structure, and caregiver education.Results: For 671 children/adolescents (10-17 years at baseline) with 5644 HbA1c observations over 11 years, four trajectories/groups were identified: 1) on target, gradual decrease (27%), 2) above target, mild increase then decrease (39%), 3) above target, moderate increase then decrease (25%), and 4) well above target, large increase then decrease (9%). Using group one as the reference, lower caregiver-reported ADQ scores predicted group 2, 3, and 4 membership. Lower child/adolescent-reported ADQ scores predicted group 3 and 4 mem-bership. Low caregiver education predicted group 3 and 4 membership. Single-parent status predicted group 4 membership.Conclusions: ADQ scores and socio-demographics may serve as tools to predict glycemic control in youth with type 1 diabetes.

Automated summary

This study aimed to identify 11-year HbA1c trajectories in children/adolescents with type 1 diabetes and determine if baseline caregiver and/or child/adolescent-reported ADQ scores and multiple covariates predict HbA1c trajectory membership. The results showed that ADQ scores and socio-demographic factors could serve as tools to predict glycemic control in youth with type 1 diabetes.