Pediatric diabetes centres rated parental responsibility and family support as most important determinants of HbA1c using a 17-item questionnaire: a pilot study

<p>In the last decades, HbA1c levels in young diabetic patients have decreased. However differences in metabolic control still exists between pediatric diabetes centers (PDC) [1-2].</p> <p>Few studies have been undertaken to explain the between-center HbA1c differences. Nevertheless we know that the metabolic control is not only dependent on the treatment prescribed but also on other factors such as biological, socio-demographic and psychosocial factors which are beyond the control of care providers and may be different between centers [3].</p> <p>Thus a "simple" comparison of HbA1c does not reflect the real differences of the quality of care given by different centers. In order to have a proper comparison, consideration must be taken for those external factors’ impact on HbA1c levels (i.e. risk-adjustment).</p> <p>Based on a pilot project, we wanted to identify psychosocial factors of which PDCs thought that they can positively or negatively influence the level of HbA1c in type 1 diabetes during childhood and adolescence. The factors that PDCs scored highly are potential factors which should be corrected for when mean HbA1c is compared between centers.</p> <p>High parental responsability and family support were scored as the most important contributing factors for EH. - A wider set of factors scored highly with regard to PH. But parental responsibility and family support remained among the highest ranking contributors, together with adolescence. - When a known risk factor for PH was present (e.g. adolescence), PDCs also scored this factor highly. - A qualitative analysis of free-text reasons for EH and PH provided information on how to improve the questionnaire for future studies (items on motivation and comorbidities). - There is evidence that due to the relatively low participation rate, the results may not be representative for all Belgian patients.</p>