To identify correlates of hemoglobin A_1c (HbA_1c) testing frequency and associations with HbA_1c levels and microvascular complications in youth-onset diabetes.

The SEARCH for Diabetes in Youth study collected data from individuals diagnosed with diabetes before age 20 at 8 years (n = 1,885 type 1, n = 230 type 2) and 13 years (n = 649 type 1, n = 84 type 2) diabetes duration. We identified correlates of reporting ≥3 HbA_1c tests/year using logistic regression. We examined associations of HbA_1c testing with HbA_1c levels and microvascular complications (retinopathy, neuropathy, or nephropathy) using sequentially adjusted linear and logistic regression.

For type 1 diabetes, odds of reporting ≥3 HbA_1c tests/year at 8 and 13 years diabetes duration decreased with older age at diagnosis (odds ratio [OR] 0.91 [95% CI 0.88–0.95]), longer duration of diabetes (OR 0.90 [0.82–0.99]), not having a personal doctor (OR 0.44 [0.30–0.65]), and lapses in health insurance (OR 0.51 [0.27–0.96]). HbA_1c testing ≥3 times/year over time was associated with lower HbA_1c levels (OR –0.36% [–0.65 to –0.06]) and lower odds of microvascular complications (OR 0.64 [0.43–0.97]) at 13 years’ duration, but associations were attenuated after adjustment for HbA_1c testing correlates (OR –0.17 [–0.46 to 0.13] and 0.70 [0.46–1.07], respectively). For type 2 diabetes, not seeing an endocrinologist decreased the odds of reporting ≥3 HbA_1c tests/year over time (OR 0.19 [0.06–0.63]), but HbA_1c testing frequency was not associated with HbA_1c levels or microvascular complications.

We observed disparities in HbA_1c testing frequency predominately by health care–related factors, which were associated with diabetes outcomes in type 1 diabetes.

确定血红蛋白 A _1c (HbA _1c ) 检测频率的相关性以及与 HbA _1c水平和青年发病糖尿病微血管并发症的关联。

SEARCH for Diabetes in Youth 研究收集了 8 岁（n = 1,885 1 型，n = 230 2 型）和 13 岁（n = 649 1 型，n = 84 2 型）糖尿病患者的数据。期间。我们使用逻辑回归确定了报告≥3 HbA _{1c测试/年的相关性。}我们使用顺序调整的线性和逻辑回归检查了 HbA _1c检测与 HbA _1c水平和微血管并发症（视网膜病变、神经病变或肾病）的关联。

对于 1 型糖尿病，在 8 年和 13 年糖尿病病程中报告 ≥3 次 HbA _1c检测/年的几率随着诊断时年龄的增长（优势比 [OR] 0.91 [95% CI 0.88–0.95]）、糖尿病病程的延长而降低（ OR 0.90 [0.82–0.99]），没有私人医生（OR 0.44 [0.30–0.65]），以及医疗保险失效（OR 0.51 [0.27–0.96]）。随着时间的推移， HbA _1c检测≥3 次/年与较低的 HbA _1c水平（OR –0.36% [–0.65 至 –0.06]）和 13 年期间微血管并发症的几率降低（OR 0.64 [0.43–0.97]）相关，但在调整 HbA _1c后相关性减弱测试相关性（OR –0.17 [–0.46 to 0.13] 和 0.70 [0.46–1.07]，分别）。对于 2 型糖尿病，随着时间的推移，不看内分泌科医生会降低报告 ≥3 HbA _1c检测/年的几率（OR 0.19 [0.06–0.63]），但 HbA _1c检测频率与 HbA _1c水平或微血管并发症无关。

_{我们观察到 HbA 1c}检测频率的差异主要受医疗保健相关因素影响，这些因素与 1 型糖尿病患者的糖尿病结局相关。