Intensive diabetes management in adolescents with type 1 diabetes: The importance of intensive follow-up

Minimal information exists on the education and follow-up required to succe ssfully initiate intensive diabetes management (IDM) in adolescents with ty pe 1 diabetes. We performed a retrospective analysis of HbA(1c) 3 and 15 mo nths after initiation of IDM in two cohorts: (1) 17 patients who received i ndividualised education in IDM and intensive early follow-up, and (2) 11 pa tients who participated in group education for initiation of IDM with stand ard follow-up, Entry HbA(1c) was higher in the individualised education pat ients (9.5+/-0.3% [mean+/-SE] versus 8.2+/-0.4%, p=0.02). After 3 months of IDM, HbA(1c) improved in both cohorts reaching similar levels (individuali sed: 7.0+/-0.1%, p<0.0001 vs entry; group: 7.3+/-0.2%, p=0.05). During the following year, with routine follow-up for both cohorts, HbA(1c) levels ros e approximately 1% as patients reverted to a multiple daily injection regim en, Irrespective of the educational approach. we believe maintenance of IDM and optimal HbA(1c) requires long-term intensive follow-up.