Differences in theManagement of Type 1 Diabetes Among Adults Under Excellent Control ComparedWith Those Under Poor Control in the T1D Exchange Clinic Registry

OBJECTIVEdOptimizing glycemic control in type 1 diabetes is important to minimize the risk of complications. We used the large T1D Exchange Clinic Registry database to identify characteristics and diabetes management techniques in adults with type 1 diabetes, differentiat-ing those under excellent glycemic control from those with poorer control. RESEARCHDESIGNANDMETHODSdThe cross-sectional analysis included 627 par-ticipants withHbA1c,6.5 % (excellent control) and 1,267with HbA1c$8.5 % (fair/poor control) at enrollment who were $26 years of age (mean 6 SD 45.9 6 13.2 years), were not using continuous glucose monitoring, and had type 1 diabetes for $2 years (22.8 6 13.0 years). RESULTSdCompared with the fair/poor control group, participants in the excellent control group had higher socioeconomic status, were more likely to be older andmarried, were less likely to be overweight, were more likely to exercise frequently, and had lower total daily insulin dose per kilogram (P, 0.0001 for each). Excellent control was associated with more frequent self-monitoring of blood glucose (SMBG), giving mealtime boluses before a meal rather than at the time of or after a meal, performing SMBG before giving a bolus, and missing an insulin dose less frequently (P, 0.0001 for each). Frequency of severe hypoglycemiawas similar between groups