Is poor metabolic control inevitable in adolescents with type 1 diabetes
Bibliographic record
Abstract
INTRODUCTION Numerous studies provide evidence that metabolic control deteriorates during adolescence in those with type 1 diabetes compared to younger children and adults1-4. Recently, in an evaluation of 2873 children and teens with type 1 diabetes from 17 countries, adolescents were found to have higher HbA1c levels than younger children, and fewer (29 versus 41%) could be considered in “good” metabolic control defined by HbA1c levels <8%3. Furthermore, in the Diabetes Control and Complications Trial (DCCT), the adolescents achieved HbA1c levels that were, on average, 1% higher than those in the adults in both the conventional and intensive treatment cohorts1. Of note, in all of these studies, higher HbA1c levels were reported even though the teens were receiving a higher insulin dosage (in units/kg) than prepubertal or adult subjects1,3. This article explores the biologic/physiologic and psychologic/psychosocial factors that may account for rising HbA1c levels during adolescence. We conclude that insulin resistance of puberty is an important factor which contributes to, and is a consequence of, poor metabolic control.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".