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Expecting factors for inadequate glycemic control in children and adolescents with type 1 diabetes mellitus: a single center experience

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Abstract

Objectives

Achieving an ideal glycemic control in children and adolescents with type 1 diabetes mellitus (T1DM) is both a difficult and challenging process. We aim to highlight the expected factors contributing to inadequate glycemic control in children and adolescents with T1DM in a sample of Iraqi children and adolescents.

Methods

This was a descriptive cross-sectional study that recruited 247 T1DM patients aged < 18 years & disease duration ≥ 1 year. Data collected included socio-demographic & clinical characteristics with recent HbA1c value. Each patient was examined for signs of puberty and any lipodystrophy at insulin injection sites. Factors studied using Independent-Samples T-Test, One way ANOVA & Multivariable logistic regression.

Results

Of the 247 patients, 108 (43.7%) were males, and 139 (56.3%) were females. The mean & SD of the age of patients was 10.13 ± 3.85 years. The Mean & SD of the recent HbA1c level was 9.43 ± 2.56. HbA1c ≤ 7.5 was achieved in 27.1% of patients. Using Multivariable logistic regression to study the association between variable factors and inadequate glycemic control, showed a significant association with higher odds in terms of the older age of the patient, maternal illiteracy, presence of recurrent diabetic ketoacidosis (DKA) episodes, absence of carb counting, and presence of lipodystrophy. Higher HbA1c was also associated significantly with puberty, rural residency, poor socioeconomic status, DKA presentation, and using regular + NPH insulin regimen.

Conclusions

In the current study, inadequate glycemic control was induced by many factors, Strategies should be applied to control these factors to minimize the prospective risks of macro-vascular complications linked to T1DM in children & adolescents.

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Data availability

The data supporting the conclusions of this study can be obtained from the corresponding author upon a reasonable request.

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Acknowledgements

The author acknowledge all the staff members at pediatric Endocrinology and Diabetes Clinic in Al-Khansaa Teaching Hospital in Mosul City, Iraq, For there help & support during the period of data collection.

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  1. Department of Pediatrics, College of Medicine, University of Mosul, Mosul, Iraq

    Farah Sameer Yahya

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Yahya, F.S. Expecting factors for inadequate glycemic control in children and adolescents with type 1 diabetes mellitus: a single center experience. J Diabetes Metab Disord (2024). https://doi.org/10.1007/s40200-024-01442-2

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