To Örebro University

Background and Aims: The development of diabetes technology is rapid and needs both education and resources to be successfully implemented in diabetes care management. The aims were to identify factors associated with glucose control andcosts.

Methods: In an observational study we evaluated the use of advanced diabetes technology, resource utilization, glycemic control, and costs. The study population was all T1D individuals in the Region Halland in Sweden. The study cohort was followed for 7 years (2013-2019).

Results: Children aged 0-17 years have significantly better glucose control than young adults aged 18-25 years. The mean HbA1c difference between children and young adults was 8 mmol/mol. Significant difference was noted from 6 months after diabetes diagnoses and onwards. Co-morbidities such as ADHD, anxiety, depression, and eating disorders were associated with higher HbA1c. All groups, irrelevant of age and co-morbidity, had positive effect on glucose control after a visit to a dietitian or psychologist. Differences were found between the age groups in terms of more advanced diabetes technology and more frequent visits to a physician in children.

Conclusions: More frequent visits to physicians, dietitians, and psychologists are linked to improved glucose control. Increased resources including access to more advanced technology are required in young adults. A young adult diabetes team could be implemented to mitigate this inequality between age groups found in our study. Increased resources and strategies to improve glucose control, will likely lead to numerous positive effects, reduction of the burden of disease, and reduction of long-term costs in T1D.