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

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...

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Autores principales: Mohammad, Hanaa A., Farghaly, Hekma S., Metwalley, Kotb A., Monazea, Eman M., Abd El-Hafeez, Heba A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475907/
https://www.ncbi.nlm.nih.gov/pubmed/23087867
http://dx.doi.org/10.4103/2230-8210.100679
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author Mohammad, Hanaa A.
Farghaly, Hekma S.
Metwalley, Kotb A.
Monazea, Eman M.
Abd El-Hafeez, Heba A.
author_facet Mohammad, Hanaa A.
Farghaly, Hekma S.
Metwalley, Kotb A.
Monazea, Eman M.
Abd El-Hafeez, Heba A.
author_sort Mohammad, Hanaa A.
collection PubMed
description 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 .
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spelling pubmed-34759072012-10-19 Predictors of glycemic control in children with Type 1 diabetes mellitus in Assiut-Egypt Mohammad, Hanaa A. Farghaly, Hekma S. Metwalley, Kotb A. Monazea, Eman M. Abd El-Hafeez, Heba A. Indian J Endocrinol Metab Original Article 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 . Medknow Publications & Media Pvt Ltd 2012 /pmc/articles/PMC3475907/ /pubmed/23087867 http://dx.doi.org/10.4103/2230-8210.100679 Text en Copyright: © Indian Journal of Endocrinology and Metabolism http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Mohammad, Hanaa A.
Farghaly, Hekma S.
Metwalley, Kotb A.
Monazea, Eman M.
Abd El-Hafeez, Heba A.
Predictors of glycemic control in children with Type 1 diabetes mellitus in Assiut-Egypt
title Predictors of glycemic control in children with Type 1 diabetes mellitus in Assiut-Egypt
title_full Predictors of glycemic control in children with Type 1 diabetes mellitus in Assiut-Egypt
title_fullStr Predictors of glycemic control in children with Type 1 diabetes mellitus in Assiut-Egypt
title_full_unstemmed Predictors of glycemic control in children with Type 1 diabetes mellitus in Assiut-Egypt
title_short Predictors of glycemic control in children with Type 1 diabetes mellitus in Assiut-Egypt
title_sort predictors of glycemic control in children with type 1 diabetes mellitus in assiut-egypt
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475907/
https://www.ncbi.nlm.nih.gov/pubmed/23087867
http://dx.doi.org/10.4103/2230-8210.100679
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