Adherence to oral glucose tolerance testing in children in stage 1 of type 1 diabetes: The TEDDY study

Kimberly A. Driscoll, Roy Tamura, Suzanne Bennett Johnson, Patricia Gesualdo, Joanna Clasen, Laura Smith, Laura Jacobsen, Helena Elding Larsson, Michael J. Haller, TEDDY Study Group

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To examine adherence to the oral glucose tolerance test (OGTT) in multiple islet autoantibody children in stage 1 of developing type 1 diabetes (T1D). Methods: Children are followed from birth in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Completion of an OGTT is recommended every 6 months in children ≥3 years of age who are multiple islet autoantibody positive. Factors associated with adherence to the OGTT protocol were examined. Results: The average subject level adherence with the OGTT protocol was 62% although there were large differences across countries; Finnish participants and older children from Sweden were more adherent than participants from the United States and Germany. Factors associated with nonadherence included having a first-degree relative with T1D, using a local laboratory rather than a TEDDY center for the OGTT, and maternal underestimation of the child's risk for T1D. Children were more adherent to the OGTT if their mothers: were more satisfied with TEDDY participation, reported monitoring the child for T1D by checking blood glucose levels at home, and viewed participating in TEDDY as the primary way they were monitoring the child for T1D. Conclusions: In a study of children in stage 1 of T1D, adherence to an OGTT protocol was suboptimal despite extensive efforts to communicate the child's high risk to parents. These findings provide important guidance for development of strategies to improve methods for detecting progression or the development of T1D in high-risk pediatric populations.

Original languageEnglish
Pages (from-to)360-368
JournalPediatric Diabetes
Volume22
Issue number2
Early online date2020 Dec 20
DOIs
Publication statusPublished - 2021

Subject classification (UKÄ)

  • Endocrinology and Diabetes

Free keywords

  • genetic risk
  • genetic studies
  • stage 1 type 1 diabetes

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