Comparable glycemic outcomes for pediatric type 1 diabetes patients in metropolitan and non‐metropolitan regions of Western Australia: A population‐based study

摘要

Background Pediatric patients diagnosed with type 1 diabetes ( T1D ) in Western Australia ( WA ) are managed by a single, specialist multidisciplinary diabetes service based at a central tertiary hospital in the capital city, Perth, which provides outreach care in regional centers. Objective To investigate the hypothesis that outcomes for a contemporary, population‐based pediatric T1D cohort, managed by a single tertiary service are similar for metropolitan and non‐metropolitan patients using this model of care. To confirm that the cohort is indeed population based, a secondary aim of the study was to determine the case ascertainment of the Western Australian Children's Diabetes Database ( WACDD ). Methods Data for all T1D patients aged 18?years, who attended the diabetes clinics (metropolitan and non‐metropolitan), at least once in 2014, were extracted from the WACDD and outcomes including HbA1c and severe hypoglycemia ( SH ) rates analyzed. Results In 2014, a total of 1017 patients (492 females, 525 males) attended the diabetes clinics (54% metropolitan and 46% non‐metropolitan). After adjusting for age, sex, diabetes duration, and insulin regimen, region of clinic was not a significant predictor of mean HbA1c or SH rate. The case ascertainment of the WACDD was estimated to be 99.9% complete for children diagnosed with T1D aged 15?years between 2002 and 2012. Conclusions This study reports similar glycemic outcomes for patients attending diabetes clinics in metropolitan and non‐metropolitan areas of WA , suggesting that a model of care provided as outreach from a specialized diabetes service is effective in achieving equitable glycemic outcomes.