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Glycemic control among children with type 1 diabetes mellitus and its determinants in a resource-limited setting
Bereket Fantahun1, Tigist W Leulseged1
1Department of Pediatrics, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Insights
Most children with type one diabetes mellitus (T1DM) have poor glycemic control. Younger age, longer disease duration, and urban residence were linked to better glycemic control in this Ethiopian study.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Diabetes Mellitus Research
Background:
- Glycemic control is crucial for predicting long-term diabetes mellitus complications.
- Identifying factors influencing glycemic control is essential for improving patient outcomes.
- Conventional insulin regimens are common for managing type one diabetes mellitus in children.
Purpose of the Study:
- To assess glycemic control in children with type one diabetes mellitus (T1DM) on conventional insulin therapy.
- To identify factors associated with glycemic control in this pediatric population.
Main Methods:
- Retrospective cohort study conducted in Addis Ababa, Ethiopia (November 2015 - November 2020).
- Included 106 children with T1DM on conventional insulin therapy.
- Glycemic control assessed using glycosylated hemoglobin (HbA1c) levels.
Main Results:
- The average HbA1c was 9.7%, with 85.2% of children exhibiting poor glycemic control (>7.5%).
- Median age at diagnosis was nine years; 47.2% were female, and 57.5% resided in urban areas.
- Younger age, longer disease duration, and urban residence were significant predictors of good glycemic control.
Conclusions:
- A substantial majority of children with T1DM experience poor glycemic control.
- Urgent need for improved access to intensive diabetes care by health authorities to prevent long-term complications.
Objectives:
Glycemic control is an important parameter that can predict long-term complications of diabetes mellitus. It can be affected by many factors. Hence, identifying those factors for improving disease outcomes is essential. The purpose of this study was to assess glycemic control in children who were treated with a conventional insulin regimen and to identify its associated factors.
Methods:
A retrospective cohort study was conducted among children with type one diabetes mellitus (T1DM) who had follow-up from November 2015 to November 2020 at the pediatric endocrinology clinic of St. Paul's Hospital Millennium Medical College in Addis Ababa, Ethiopia. Glycemic control was assessed by measuring glycosylated hemoglobin (HbA1C) and children who had HbA1C within three to six months of the data collection were recruited.
Results:
A total of 106 children with TIDM who were on conventional insulin therapy were included in this study. Their median age at diagnosis was nine years, 47.2% were females, and 57.5% were from urban areas. The average HbA1c of the children was 9.7%. The majority (85.2%) of the children had poor glycemic control (>7.5%). Younger age, longer disease duration, and urban residence were found to be significant predictors of good glycemic control.
Conclusions:
A significant majority of children with T1DM had poor glycemic control. This calls for the need to create access to intensive diabetes care by health authorities and stakeholders to prevent the long-term complications of T1DM.
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