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Glycaemic control and factors affecting it in type 1 diabetes in children: experience from a tertiary care centre in
Devi Dayal1, Jaivinder Yadav1, Rakesh Kumar1
1Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Optimal glycaemic control in type 1 diabetes (T1D) is crucial for preventing complications. This study in India found that longer disease duration, DKA episodes, and lower parental education negatively impact glycemic control, highlighting the need for targeted diabetes education.
Area of Science:
- Pediatrics
- Endocrinology
- Public Health
Background:
- Optimal glycemic control is vital for preventing micro- and macrovascular complications in type 1 diabetes (T1D).
- Factors influencing glycemic control include insulin type, delivery device, caregiver knowledge, patient age, diabetes duration, and blood glucose monitoring.
- This study investigates glycemic control and its determinants in T1D patients at a tertiary care center in northern India.
Purpose of the Study:
- To analyze glycemic control in children and adolescents with type 1 diabetes.
- To identify demographic and disease-related factors affecting glycemic control in this population.
Main Methods:
- A retrospective review of patient records from 2015 to 2018.
- Data collection included demographic and disease-related factors.
- Statistical analysis using t-test, one-way ANOVA, and Kruskal-Wallis test.
Main Results:
- The mean age was 10.43 ±4.04 years, with a mean disease duration of 46.61 ±28.49 months.
- Mean HbA1c was 7.96 ±1.46%, with only 24% achieving the ISPAD recommended level (<7%).
- Higher HbA1c levels were associated with longer disease duration, DKA episodes, lower parental education, and hyperthyroid state. Dyslipidaemia was the most common complication.
Conclusions:
- Targeted diabetes education for parents, especially those with lower education levels, is essential.
- Interventions should address children with longer disease duration and poor compliance to improve glycemic control in India.
- Improving glycemic control is critical for preventing long-term complications in T1D patients in developing countries.
Introduction:
Optimal glycaemic control is essential for the prevention of future micro- and macrovascular complications in type 1 diabetes (T1D). The type of insulin, the type of insulin delivery device, the caregiver's knowledge, the patient's age, duration of diabetes, and self-monitoring of blood glucose affect glycaemic control in type 1 diabetes. In the present study, we analysed glycaemic control and factors affecting it at a tertiary care centre in northern India.
Material And Methods:
A retrospective review of records of patients registered between 2015 and 2018 was done. The data on demographic and disease-related factors were collected from the records. The different groups were compared with the t-test, one-way ANOVA, or Kruskal-Wallis test.
Results:
The mean age at the time of evaluation was 10.43 ±4.04 years (2-21 years), and the mean disease duration was 46.61 ±28.49 months (16-141 months). Most of the patients were prepubertal and using a basal-bolus regimen. The mean glycated haemoglobin (HbA1c ) was 7.96 ±1.46%, but only 24% had HbA1c below the International Society of Paediatric and Adolescent Diabetes (ISPAD) recommended desirable level of below 7%. Forty-six patients suffered one or more micro-macrovascular complications, and dyslipidaemia was the most common complication. Children with a longer duration of disease (8.39 ±1.42% vs. 7.59 ±1.65%), an episode of DKA (diabetes ketoacidosis) within a year of evaluation (9.19 ±2.54% vs. 7.93 ±1.39%), lower maternal (8.22 ±1.37% vs. 7.56 ±1.45%) and paternal education (8.26 ±1.67% vs. 7.78 ±1.30%), and hyperthyroid state (9.43 ±2.28% vs. 7.91 ±1.45%) had higher HbA1c.
Conclusions:
Better diabetes education focusing on parents with lower education strata and children with longer disease duration and poor compliance can help improve glycaemic control in developing countries like India.
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