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.

Keywords

• Glycemic management
• Type 1 diabetes
• Children
• Adolescent
• mHealth
• HbA1c