More than two-thirds of children with type 1 or insulin-dependent diabetes who receive intensive treatment are able to attain tight control of blood sugar in line with current recommendations, a study shows.

The findings of the Diabetes Control and Complications Trial (DCCT) have “revolutionized” treatment of type 1 diabetes by demonstrating the importance of lowering the blood sugar and hemoglobin A1C to as close to normal as possible, Dr. Stuart A. Weinzimer and colleagues from Yale University in New Haven, Connecticut, note in the Journal of Pediatrics.

Maintaining tight control of blood sugar levels in diabetics has been shown to reduce their risk of developing complications of diabetes such as eye and kidney disease.

Weinzimer and colleagues examined factors that might interfere with optimal blood sugar control in children and adolescents with type 1 diabetes in the context of an intensive treatment program.

A total of 455 diabetic children were included in the study. Their average age was 11.8 years, and they had had diabetes for a mean duration of 4.9 years. More than 60 percent of the patients were using insulin pump therapy.

The mean hemoglobin A1C level for the cohort was 7.6 percent. Overall, 31 percent of the subjects failed to meet the blood sugar goal of 8.0 percent.

Low socioeconomic status, but not race/ethnicity, was associated with poor control of blood sugar.

However, “even our low-income families achieved a degree of metabolic control of diabetes that compared well with international standards,” Weinzimer and colleagues report.

“On the other hand, there remains a small core of patients with multiple risk factors who continue to do very poorly,” they note. “New strategies are needed to help these patients achieve better control of their diabetes.”

SOURCE: Journal of Pediatrics August 2006.