Diabetes care, psychosocial, and behavioral factors according to weight-glycemia clusters 1–6
| Characteristics, mean (SD) or n (%) | All n=1817 | Weight-glycemia cluster | ||||||
| Cluster 1 n=618 (34.0%) | Cluster 2 n=195 (10.7%) | Cluster 3 n=509 (28.0%) | Cluster 4 n=79 (4.4%) | Cluster 5 n=137 (7.5%) | Cluster 6 n=279 (15.4%) | P value† | ||
| Diabetescarefactors | ||||||||
| Insulin regimen | <0.0001 | |||||||
| Pump | 1036 (57.0) | 446 (72.2) | 125 (64.1)* | 246 (48.3)** | 22 (27.9)** | 29 (21.2)** | 168 (60.2)** | |
| Long+short/rapid insulin, 3+ times/day | 341 (18.8) | 84 (13.6) | 38 (19.5)* | 100 (19.7)** | 25 (31.7)** | 44 (32.1)** | 50 (17.9)** | |
| Long+other combination‡ | 440 (24.2) | 88 (14.2) | 32 (16.4)* | 163 (32.0)** | 32 (40.5)** | 64 (46.7)** | 61 (21.9)** | |
| Insulin dose (daily units/kg) | 0.86 (0.38) | 0.80 (0.40) | 0.78 (0.31)* | 0.90 (0.34)** | 1.00 (0.42)** | 1.01 (0.48)** | 0.84 (0.32)* | <0.0001 |
| Blood glucose monitoring frequency | <0.0001 | |||||||
| <1/day | 107 (5.9) | 15 (2.4) | 8 (4.1)* | 39 (7.7)** | 9 (11.4)** | 25 (18.3)** | 11 (3.9)** | |
| 2–4×/day | 501 (27.6) | 90 (14.6) | 46 (23.6)* | 197 (38.7)** | 40 (50.6)** | 62 (45.3)** | 66 (23.7)** | |
| >4×/day | 1209 (66.5) | 513 (83.0) | 141 (72.3)* | 273 (53.6)** | 30 (38.0)** | 50 (36.5)** | 202 (72.4)** | |
| Acute complications (past 6 months)§ | ||||||||
| 1+ severe hypoglycemic episode | 130 (7.2) | 56 (9.1) | 10 (5.1) | 28 (5.5)* | 4 (5.1) | 6 (4.4) | 26 (9.3) | 0.273 |
| 1+ diabetic ketoacidosis episode | 332 (18.3) | 61 (9.9) | 25 (12.8) | 124 (24.4)** | 30 (38.0)** | 56 (40.9)** | 36 (12.9) | <0.0001 |
| Diabetes care provider | 0.507 | |||||||
| Pediatric endocrinologist | 1007 (55.4) | 332 (53.7) | 108 (55.4) | 303 (58.5)* | 40 (50.6) | 67 (48.9) | 157 (56.5) | |
| Adult endocrinologist | 344 (18.9) | 136 (22.0) | 31 (15.9) | 82 (16.1)* | 15 (19.0) | 26 (19.0) | 54 (19.4) | |
| All other¶ | 466 (25.6) | 150 (24.3) | 56 (28.7) | 124 (24.4)* | 24 (30.4) | 44 (31.1) | 68 (24.4) | |
| Psychosocialfactors | ||||||||
| Depressive symptoms (CESD score)†† | 10.1 (8.7) | 7.8 (7.4) | 8.3 (7.8) | 12.1 (8.8)** | 12.7 (11.0)** | 15.3 (10.2)** | 9.8 (8.4)** | <0.0001 |
| Quality of life (PedsQL score)‡‡ | 82.3 (13.3) | 85.3 (12.1) | 85.4 (11.0) | 79.9 (13.3)** | 77.7 (16.8)** | 75.9 (14.2)** | 82.1 (13.1)** | <0.0001 |
| Lifestylebehavioralfactors | ||||||||
| Adherence to DASH diet§§ | 46.5 (9.4) | 48.7 (9.1) | 46.7 (8.6)* | 45.3 (9.5)** | 44.0 (9.0)** | 44.9 (8.8)** | 45.2 (9.8)** | <0.0001 |
| Total energy intake (kcal) | 1699 (788) | 1694 (760) | 1623 (688) | 1746 (860) | 1960 (1153)* | 1791 (764)* | 1559 (623)* | 0.010 |
| Total energy from fat (%) | 37.5 (6.2) | 36.8 (6.0) | 37.3 (6.6) | 38.0 (6.3)* | 37.5 (5.9) | 38.0 (6.1) | 38.0 (6.1) | 0.188 |
| Total energy from carbohydrate (%) | 48.1 (8.2) | 49.1 (7.8) | 48.3 (8.5) | 47.6 (8.6)* | 48.2 (7.8) | 47.0 (8.3)* | 47.1 (7.9)** | 0.060 |
| Total energy from protein (%) | 16.1 (2.6) | 16.1 (2.5) | 16.3 (2.5) | 16.0 (2.7) | 15.7 (2.4) | 16.4 (2.8) | 16.5 (2.5) | 0.300 |
| Physically active¶¶ | 1063 (58.5) | 429 (69.4) | 118 (60.5)* | 264 (51.9)** | 36 (45.6)** | 69 (50.4)** | 147 (52.7)** | <0.0001 |
| High screen time¶¶ | 924 (50.9) | 234 (37.9) | 78 (40.0) | 309 (60.7)** | 57 (72.2)** | 96 (70.1)** | 150 (53.8)** | <0.0001 |
All measures are from the cohort visit.
Missing data: n=4 for 1+ diabetic ketoacidosis episodes. n=174 for DASH score, total energy, total energy from carbohydrate, total energy from protein, and total energy from fat. Missingness not different across clusters (p>0.05).
*Significant pairwise comparison to cluster 1, where q<0.05.
†Bonferroni-corrected p value for overall test of difference, based on use of analysis of variance (ANOVA), χ2 or Fisher’s exact test as appropriate.
‡Includes 2+ times/day or any insulin combination (excluding long), 3+ times/day or any insulin(s) taken 1×/day, or any insulin combination (excluding long) 2+/day.
§Self-reported, in the past 6 months.
¶Includes family practice doctor, general practice doctor, internist, nurse diabetes educator, nurse practitioner/physician’s assistant, dietician/nutritionist, other, unknown, and none.
**Significant pairwise comparison to Ccluster 1, where q<0.001. Controlled for the positive false discovery rate.
††Center for Epidemiologic Studies Depression Scale, total score.
‡‡Pediatric s Quality of Life Inventory, total score.
§§Dietary Approaches to Stop Hypertension diet diet, total score.
¶¶Physically active defined as exercise 3–7 days per week. High screen time defined as 2+ hours of screen- time per day.