Predictors of glycemic control in children with Type 1 diabetes mellitus in Assiut-Egypt
Open Access
- 1 January 2012
- journal article
- research article
- Published by Medknow in Indian Journal of Endocrinology and Metabolism
- Vol. 16 (5), 796-802
- https://doi.org/10.4103/2230-8210.100679
Abstract
Background : Type 1 diabetes mellitus (T1DM) may lead to severe long-term health consequences, such as renal failure, blindness, as well as heart and cerebrovascular disease. Although a direct relationship between blood glucose control and diabetes complications remains to be established beyond doubt, most diabetologists aim to achieve the best possible glucose control in their patients with T1DM. The aim of this study was to detect the predictors of glycemic control among children with T1DM in Assiut Governorate-Egypt. Materials and Methods : We enrolled 415 children aged 2 to 18 years with type 1 diabetes of >1-year duration. They were subjected to full history including demographic factors and disease-related factors. Examination was done with determination of the body mass index, and assessment of stage of maturity. Investigations included hemoglobin A1c (HbA1c) and lipid profile. Patients with HbA1c above the recommended values for age by the American Diabetes Association were considered as poor glycemic control group. Results : Of the studied cases, 190 cases (45.8%) were of poor glycemic control. Patients with poor control had significantly higher mean age (16.83 ± 3.3 vs 9.77 ± 3.7, Pvs 2.40 ± 2.0, P<0.000) and were older in age at onset of disease. Insulin regimen which consists of basal bolus insulin plus three injections of regular insulin was associated with more frequency of good glycemic control than other regimens. Patients with poor control had significantly higher mean of cholesterol, triglyceride (TG), high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol than patients with good control. Adjusting for other variables, age of the patients, duration of disease, and serum TG level were significant independent risk factors of poor glycemic control. Conclusions : This study concluded that children more than 15 years, duration of disease more than 5 years, and high serum TG level are the predictors of poor glycemic control of children with T1DM in Assiut - Egypt. Pediatricians need to be aware of factors associated with poor glycemic control in children with T1DM, so that more effective measures can be implemented to prevent deterioration in diabetes control .Keywords
This publication has 30 references indexed in Scilit:
- Glycemic Control in Youth with Diabetes: The SEARCH for Diabetes in Youth StudyThe Journal of Pediatrics, 2009
- Switching from premixed insulin to glargine-based insulin regimen improves glycaemic control in patients with type 1 or type 2 diabetes: a retrospective primary care-based analysisCardiovascular Diabetology, 2009
- Temporal Trends in the Treatment of Pediatric Type 1 Diabetes and Impact on Acute OutcomesThe Journal of Pediatrics, 2007
- Social and psychological characteristics of Kuwaiti children and adolescents with type 1 diabetesSocial Science & Medicine (1982), 2005
- Self-monitoring of blood glucose in children and teens with diabetesPediatric Diabetes, 2005
- Predictors of control of diabetes: monitoring may be the keyThe Journal of Pediatrics, 2004
- Insulin injection regimens and metabolic control in an international survey of adolescents with type 1 diabetes over 3 years: results from the Hvidore study groupEuropean Journal of Pediatrics, 2003
- Puberty permits increased expression of renal transforming growth factor-?1 in experimental diabetesPediatric Nephrology, 2001
- Body mass index of 0 to 45-y-old Danes: reference values and comparison with published European reference valuesInternational Journal of Obesity, 2001
- Variations in pattern of pubertal changes in girls.Archives of Disease in Childhood, 1969