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

Research Authors
Hanaa A. Mohammad, Hekma S. Farghaly, Kotb A. Metwalley, Eman M. Monazea1 , Heba A. Abd El-Hafeez
Research Journal
Indian Journal of Endocrinology and Metabolism
Research Publisher
NULL
Research Rank
1
Research Vol
NULL
Research Website
NULL
Research Year
2012
Research_Pages
NULL
Research 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 vs9.77 ± 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 vs2.40 ± 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