Glycaemic control in transition‐aged versus early adults with type 1 diabetes and the effect of a government‐funded insulin pump programme
Bibliographic record
Abstract
Abstract Aim To compare glycaemic control and adverse outcomes between transition‐aged and early adults with type 1 diabetes, and the impact of continuous subcutaneous insulin infusion (CSII) therapy funded through a government Assisted Devices Program. Methods This retrospective cohort study using healthcare administrative databases from Ontario, Canada included adults aged 18–35 with type 1 diabetes between 1 April 2011 and 31 March 2014. Mean HbA 1c was compared between transition‐aged (18–24 years) and early adults (25–35 years), overall and stratified by whether or not they received government‐funded CSII therapy (CSII vs. non‐CSII). Secondary outcomes included rates of hospitalizations/emergency department visits for hyperglycaemia and hypoglycaemia over a 3‐year follow‐up. Comparisons were adjusted for relevant covariates. Results Among 7157 participants with type 1 diabetes, mean HbA 1c was significantly higher for transition‐aged compared to early adults (71 mmol/mol [8.68%] vs. 64 mmol/mol [8.04%], p < 0.0001). This difference was smaller among CSII compared to non‐CSII users ( p = 0.02 for interaction between age group and CSII use). The transition‐age group were more likely to experience a hyperglycaemic event compared to early adults (adjusted risk ratio, aRR: 1.56, 95% confidence interval [CI]: 1.25–1.96), which was attenuated by CSII use (aRR: 1.13, 95% CI: 0.7–1.69). Conclusions Transition‐aged adults with type 1 diabetes had a significantly higher mean HbA 1c and risk of hyperglycaemic events compared to early adults. This difference was attenuated for CSII users, indicating that a government‐funded CSII programme is associated with narrowing of the gap in glycaemic control and associated adverse outcomes for this population.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".