Glycemic Control Among Children with Type 1 Diabetes Mellitus in Northern Areas of Pakistan

Abstract

Objective: To find the glycemic control in type 1 diabetes mellitus (T1DM) children and highlight the factors associated with its poor control.

Study Design: Cross-sectional study

Place and Duration of Study: This study was conducted at the Ayub Teaching Hospital, Pediatrics ward for a duration of two years from January 2019 to April 2021.

Materials and Methods: By convenient sampling technique, total 53 patients were included in the study. After ethical approval from institutional ethical review committee, and ensuring the inclusion/exclusion criteria, HbA1C was measured in all patients. Children with glycated haemoglobin (HbA1C) equal to 8.0% or less were categorized as having good control. Data were recorded on a proforma and then entered in IBM SPSS (Version 21). For seeing the association between dependent (glycemic control) and independent variables (age, gender, anthropometric variables and) chai square test was used. A P-value less than 0.05 was considered significant.

Results: Total 53(100%) children of mean age 10.18 ± 5.278 years with a mean height of 123.01 ± 25.909 centimeters, the weight of 25.22±14.066 kilograms were included in the study. Their mean HbA1C level was 10.90±2.475%. The incidence of poor glycemic control (PGC) appeared alarming i.e., 46(86.8%).  While comparing glycemic controls of T1DM patients with gender, socioeconomic status, parents’ literacy etc., none of the p-values was significant. The majority of patients i.e.,22(41.5%) with PGC presented with diabetes ketoacidosis.

Conclusion: The PGC with a high level of HbA1c in the Northern area of Pakistan is perturbing. Educating caregivers especially about recognizing early clinical presentation and adhering to strict glycemic control is required.