Longitudinal Patterns of HBA1c Trajectories in Patients with Type 1 Diabetes
Bibliographic record
Abstract
Introduction: Type 1 diabetes is a chronic condition that affects adolescents’ quality of life and raises the risk of developing mental health concerns and diabetes-related complications. Measuring glycated hemoglobin (HbA1c) over time is the standard of care within the management of type 1 diabetes; however, the determinants of different HbA1c trajectories remain poorly understood. In the secondary analysis of the data collected for the Integrated Care Model (1), we aimed to identify groups of HbA1c trajectories with similar trends and examine the association between these groups and demographic and psychosocial variables. Methods: HbA1c data were collected at 4 consecutive time points with a gap of 3±1 months. We used Leffondré’s method (2) and Group-based trajectory modeling (GBTM) (3) to derive the groups of HbA1c trajectories among 91 adolescents. Baseline characteristics of the adolescents included in the groups were analyzed by univariate analysis. Results: Leffondré’s method identified three groups of trajectories: stable (63%), decreasing (17%), and increasing (20%). The baseline HbA1c levels for the three groups were 8.00±0.93, 10.07±1.63, and 8.21±1.14, respectively. Among the baseline characteristics, only the treatment method distinguished the groups of adolescents with similar trajectories of HbA1c over time (p=0.015). The GBTM method identified similar groups: stable (67%), decreasing (18%) and increasing (15%). The baseline HbA1c levels for the three groups were 7.89±0.88, 9.81±1.61, and 9.00±1.38, respectively. Groups produced by GBTM were also distinguished by treatment modality at baseline (p=0.022). Discussion: We identified three distinct patterns of HbA1c trajectories in adolescents. The only baseline characteristic that significantly distinguished these trajectories was the treatment modality. References J. Versloot, et al., An Integrated Care Model to Support Adolescents With Diabetes-related Quality-of-life Concerns: An Intervention Study. Can J Diabetes (2022). K. Leffondré, et al., Statistical measures were proposed for identifying longitudinal patterns of change in quantitative health indicators. J Clin Epidemiol 57, 1049–1062 (2004). D. S. Nagin, Group-based trajectory modeling: an overview. Ann Nutr Metab 65, 205–210 (2014).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".