Time in range and HbA(1C) after 6 months with a multidisciplinary program for children and adolescents with diabetes mellitus, real world data from Mexico City

BACKGROUND: Multidisciplinary interventions may be useful for children and adolescents with diabetes mellitus (DM), especially in areas where new blood glucose monitoring and control technologies are difficult to access. METHODS: PAANDA, a care program for adolescents and children with diabetes, was implemented in patients aged 0 to 18 years and 11 months. The effect of the intervention was determined by self‐blood glucose monitoring (SBGM) and glycosylated hemoglobin (HbA(1C)) levels at start and after 6 months. RESULTS: A total of 121 patients with DM were evaluated, mean age of 14.27 years (SD: 4.60 years). Blood glucose measurements in range (70‐120 mg/dL pre‐prandial or 70‐180 mg/dL post‐prandial) increased by 20.67% before breakfast, 8.14% after breakfast (both P‐value <.001), 5.02% before lunch (P‐value = .02), 8.66% after lunch (P‐value <.001), 11.50% before dinner (P‐value <.001), 11.87% after dinner (P‐value <.001), and 8.00% at dawn (P‐value = .001). This change was accompanied by fewer values in the hyperglycemic category (−19.49% before breakfast, −7.73% after breakfast, both P‐value <.001) and hypoglycemia (−1.18%). HbA(1C) levels decreased significantly 1.8% (P‐value = .018). Multivariate logistic regression analysis showed an increase in glycemic control associated with each month after the intervention time in the PAANDA program (P‐value <.001 for all the time points evaluated) and a significant decrease in glycemic variability. CONCLUSIONS: The multidisciplinary PAANDA intervention had a beneficial effect on glycemic control, with an improved time in range in a population of children and adolescents with DM.