The Arrival of a New Sibling May Be Associated with a Deterioration in Glycemic Control for Children with Type 1 Diabetes

Introduction: Caring for young children with Type 1 diabetes comes with significant burden for parents. We hypothesised that pregnancy and the arrival of a new sibling may be associated with a deterioration in control of type 1 diabetes for older siblings with type 1 diabetes. Research Design and Methods: We identified young children currently under the care of the John Hunter Children's Hospital Paediatric Diabetes team who had welcomed a younger sibling since their diagnosis using our prospective Paediatric Diabetes database. We reviewed the HbA1c pre and post the arrival of a new sibling. Results: 38 children (20 male) had become older siblings since diagnosis of type 1 diabetes. 5 children were excluded as no data were available prior to pregnancy. Mean age of children at diagnosis was 3.5 years. Mean age at arrival of sibling was 6years with mean duration of diabetes at that time of 3.4 years. 15 of eligible participants were using insulin pump therapy. Mean HbA1c during pregnancy was 51mmol/mol (6.8%) compared to 54mmol/mol (7.1%) following delivery (p<0.05). 67% of children had HbA1c <53mmol/mol (7%) during pregnancy compared to 53% following delivery. Conclusion: The arrival of a new sibling was associated with a significant increase in HbA1c. This may be due to the high care burden of type 1 diabetes on parents which cannot be met when also attempting to attend to the needs of a newborn. Programs to assist new parents may help children with young siblings to continue to meet glycaemic targets. Despite the young age of the cohort of children prior to delivery of a new sibling, 67% were able to meet the ADA glycaemic target of <7%. This indicates that the goals of intensive management of diabetes are achievable even in the toddler, preschool and early primary school years. Disclosure P.E.Lopez: None. B.R.King: None. C.E.Smart: None. A.Sinclair: None. M.Neylan: None. R.Seckold: None. M.A.Paterson: None.