Related Experiment Video
Updated: Jul 5, 2025
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Challenges in achieving adequate glycemic control among children with type 1 diabetes mellitus in a resource-limited
1Family Medicine Board, Sudan Medical Specialization Board, Khartoum, Sudan.
Insights
Glycemic control is poor in Sudanese children with type 1 diabetes mellitus (T1DM), especially adolescents. Factors like family structure and infrequent blood glucose monitoring impact outcomes, necessitating targeted interventions.
Area of Science:
- Pediatrics
- Endocrinology
- Public Health
Background:
- Type 1 diabetes mellitus (T1DM) is a chronic condition requiring lifelong management.
- Effective glycemic control in children is crucial for preventing long-term complications.
- Limited data exists on T1DM management in resource-limited settings like Sudan.
Purpose of the Study:
- To evaluate glycemic control in pediatric T1DM patients in Wad-Madani City, Sudan.
- To identify factors associated with glycemic control in this population.
- To inform the development of targeted interventions for improved diabetes care.
Main Methods:
- Cross-sectional observational study at a Sudanese referral center.
- Included 211 children (aged 1-18 years) with T1DM diagnosed over a year prior.
- Collected data on glycemic control, sociodemographic, and clinical characteristics.
Main Results:
- Only 6.2% achieved adequate glycemic control; adolescents showed particularly poor control (97.8%).
- Mean HbA1c was 10.4%. Poor control linked to older age, single-parent households, infrequent SMBG, and larger family size.
- High rates of DKA (33.8%), lipodystrophy (34.1%), and arthropathy (25.1%) were observed.
Conclusions:
- A very low percentage of children with T1DM achieved adequate glycemic control, with adolescents being a vulnerable group.
- Self-monitoring of blood glucose frequency and family dynamics are key factors influencing control.
- Urgent need for tailored interventions and enhanced diabetes education in resource-limited settings.
Objective:
To assess glycemic control and associated factors in children with type 1 diabetes mellitus (T1DM) attending the pediatric diabetes clinic in Wad-Madani City, Sudan.
Methods:
This cross-sectional observational study was conducted at a referral center in Sudan. The study population consisted of children aged 1-18 years who had been diagnosed with T1DM for more than 1 year and were under regular follow-up in the clinic. Data on their glycemic control and sociodemographic and clinical characteristics were captured.
Results:
Out of 211 enrolled patients, 120 (56.9 %) were females. The mean age was 11.7 years (SD = 4.0), with the mean age at diagnosis of 6.7 years (SD = 4.0). Only 6.2 % achieved adequate glycemic control. Adolescents had particularly poor control (97.8 %). The mean glycosylated hemoglobin (HBA1c) level was 10.4 % (90 mmol/mol). Inferior glycemic control was associated with advancing age, older age at diagnosis, belonging to single-parent households, less frequent self-monitoring of blood glucose (SMBG), and having a greater number of siblings or household members. A third of patients (33.8 %) had had one or more diabetes ketoacidosis (DKA) episodes in the previous year. There was a high prevalence of lipodystrophy (34.1 %) and arthropathy (25.1 %).
Conclusions:
An exceptionally low proportion of children with T1DM achieved adequate glycemic control, with adolescents particularly struggling. SMBG frequency and family dynamics emerged as potential factors, highlighting the urgent need for tailored interventions and improved diabetes education in resource-limited settings.
Related Concept Videos
01:22Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
01:22Diabetes Mellitus: Type 2 and Gestational
01:15Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
01:15Diabetes: Symptoms, Diagnosis, and Complications
01:16Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...