Glycemic control among children and adolescents with diabetes in Southern Ethiopia: a cross-sectional study

Abstract

Background Glycemic control is an important part of diabetes management. Strict glycemic control has been shown to reduce the long-term complications of diabetes. However, achieving good glycemic control is challenging for people with diabetes especially in resource limited settings. The aim of this study was to assess glycemic control and identify its determinants among children and adolescents with diabetes. Methods A cross-sectional study among 116 children and adolescents with diabetes was done at a pediatric endocrine clinic in southern Ethiopia. Data on socioeconomic, demographic, nutrition, and diabetes related variables were collected. Glycemic control was assessed based on glycosylated hemoglobin level. Logistic regression analysis was used to identify predictors of glycemic control. Results The mean glycated hemoglobin (HbA1c) of the participants was 9.6 ± 2.4% (81 ± 3 mmol/mol). Ninety seven (83.6%) of the study participants had poor glycemic control [HbA1c ≥7.5% (58 mmol/mol)]. The presence of lipodystrophic change at injection sites (p =0.028) and being from a family that cannot afford for insulin when there is no free supply (p =0.009) were associated with poor glycemic control. Conclusions The majority of children and adolescents with diabetes had poor glycemic control. Stakeholders shall focus on identifying strategies to improve the magnitude of poor glycemic control. More research is warranted to exhaustively list out factors contributing to poor glycemic control.

Poor glycemic control and its associated factors among children with type 1 diabetes mellitus in Harar, eastern Ethiopia: A cross-sectional study

“…Data were collected using a pretested, structured interviewer-administered questionnaire and a review of medical records with a validated data abstraction checklist adapted from previous studies [4,[11][12][13][14]. The tool contains information on the sociodemographic conditions of the caregiver and children such as age, sex, educational status, marital status of caregiver, occupational status, and place of residence); clinical characteristics and medication-related factors (duration of diabetes, medication duration, anthropometric parameters, insulin type, and amount, follow-up, comorbidities, and medication use and place of insulin storage); nutritional-related factors (the number of meals per day, meal content, consuming forbidden foods); and health facility related factors (frequency of clinic visits, a distance of health facility, means of transportation, counseling by a health professional, presence of health insurance).…”

“…The incidence of pediatric DM varies from 4.4 per 100,000 to 20 per 100,000 children in African countries [3]. Although there are different categories of DM, T1DM is the most prevalent in the pediatric population [4]. T1DM is a severe and longlasting progressive condition that develops when the pancreas produces insufficient amounts of insulin [5].…”

“…The most powerful modifiable predictor for the occurrence of both acute and chronic complications of diabetes is poor glycemic control. Glycemic control is a watchword given for the level of blood sugar in the diabetic population, and strict glycemic control can postpone the onset, decrease the progression of chronic diabetes complications and increase cognitive functioning, as supported by the diabetes control and complications trial [ 4 ].…”

“…This in turn leads to deprived health outcomes [ 11 ]. In LMICs, the prognosis of children with T1DM is miserable, and many children lack timely diagnosis, treatment, and monitoring which drastically shortens life expectancy to less than one year [ 4 , 11 ].…”

Evaluation of vitamin D, vitamin B12 and Hemoglobin HbA1c levels in patients with type 1 diabetes mellitus

“…Although there are many factors that predispose children to chronic complications of diabetes, the strongest predictor of diabetes is glycemic control. Since type 1 diabetes patients have to use insulin, it is very important to adjust the insulin dose in maintaining glycemic control [5,6]. Long-term glycemic control is achieved by measuring glycosylated hemoglobin (HbA1c) [7].…”