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Predictors of glycemic control in children with Type 1 diabetes mellitus in Assiut-Egypt.

Mohammad HA, Farghaly HS, Metwalley KA, Monazea EM, Abd El-Hafeez HA - Indian J Endocrinol Metab (2012)

Bottom Line: 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.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 .

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric, Faculty of Medicine, Assiut University, Assiut, Egypt.

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, P<0.000). Girls aged 15 years or more had significantly higher prevalence of poor glycemic control than males of the same age group. As regard the disease-related factors, patients with poor control had significantly longer duration of disease (7.94 ± 2.6 vs 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 .

No MeSH data available.


Related in: MedlinePlus

Percent of children with poor glycemic control by their age and sex
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Figure 1: Percent of children with poor glycemic control by their age and sex

Mentions: Sex was not significantly associated with glycemic control. Stratification of patients by age and sex [Figure 1] shows that girls 15 years or more had significantly higher percentage of poor glycemic control than males of the same age group (71.2% vs 56.7%, P = 0.04). Patients with BMI below normal had significantly higher percentage of good control than patients with normal BMI and over weights (62.5% vs 45.3% and 45.0%, P = 0.002).


Predictors of glycemic control in children with Type 1 diabetes mellitus in Assiut-Egypt.

Mohammad HA, Farghaly HS, Metwalley KA, Monazea EM, Abd El-Hafeez HA - Indian J Endocrinol Metab (2012)

Percent of children with poor glycemic control by their age and sex
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475907&req=5

Figure 1: Percent of children with poor glycemic control by their age and sex
Mentions: Sex was not significantly associated with glycemic control. Stratification of patients by age and sex [Figure 1] shows that girls 15 years or more had significantly higher percentage of poor glycemic control than males of the same age group (71.2% vs 56.7%, P = 0.04). Patients with BMI below normal had significantly higher percentage of good control than patients with normal BMI and over weights (62.5% vs 45.3% and 45.0%, P = 0.002).

Bottom Line: 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.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 .

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric, Faculty of Medicine, Assiut University, Assiut, Egypt.

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, P<0.000). Girls aged 15 years or more had significantly higher prevalence of poor glycemic control than males of the same age group. As regard the disease-related factors, patients with poor control had significantly longer duration of disease (7.94 ± 2.6 vs 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 .

No MeSH data available.


Related in: MedlinePlus