Predictors of glucose control in children and adolescents with type 1 diabetes: results of a cross-sectional study in Cameroon

Abstract

BackgroundIn sub-Saharan Africa the prognosis of children with type 1 diabetes is poor. Many are not diagnosed and those diagnosed have a dramatically reduced life expectancy (less than one year). The purpose of this study was to identify the predictors of glucose control in children and adolescents with type 1 diabetes.MethodsThis hospital based cross-sectional study involved 76 children/adolescents (35 boys and 41 girls, mean age of 15.1 ± 3.1 years) with type 1 diabetes included in the “Changing Diabetes in Children” (CDiC) program and attending the clinics for children living with type 1 diabetes in the North West Region of Cameroon. Data on glycosylated haemoglobin (HbA1c) was obtained from hospital records of participants. Information on socio-demographic characteristics and diabetes related practices were obtained from participants using a structured questionnaire. Odds ratios (OR) were calculated using logistic regression models to assess the association between determinants and good glyceamic control.ResultsThe study population had a mean HbA1c of 10.3 ± 2.9%. Bivariate analysis indicated that having a mother as the primary caregiver (OR 0.07, 95% CI 0.02–0.2), being on 2 daily insulin injections (OR 0.2, 95% CI 0.1–0.5) and good blood glucose monitoring (BGM) adherence (OR 0.1, 95% CI 0.04–0.3) were significantly (p < 0.001) associated with better HbA1c. Minimal/moderate caregiver involvement in BGM (OR 7.7, 95% CI 2.7–22.0) and insulin injection (OR 14.9, 95% CI 4.8–46.5) were significantly (p < 0.001) associated with poor outcome. Multivariate analysis showed that having a mother as the primary caregiver (OR 0.02, 95% CI 0.002–0.189) was an independent predictor of good glucose control.ConclusionsThis study has shown that the mother’s involvement in the diabetes management of their children and minimal/moderate caregiver involvement in the task of insulin injection are the most important determinants for good and poor glucose control respectively. It is currently unclear whether the direct involvement of the mother is causal or whether “mother as a primary caregiver” is just an indicator for a setting in which good diabetes treatment is possible.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-017-2534-8) contains supplementary material, which is available to authorized users.

Epidemiology of prediabetes and diabetes in Namibia, Africa: A multilevel analysis

“…Further, the vast majority of prior studies on dysglycemia among African populations have focused primarily on diabetes, with limited inclusion of prediabetes. 13,33,34 Our finding of the potentially large burden of prediabetes in Namibia portends a potentially large future epidemic of diabetes, underscoring the need for Namibian health authorities to prepare to manage commonly concurrent burdens of vascular disease and kidney disease among their citizens. Moreover, Namibia and other SSA countries are undergoing a demographic transition that may hasten the population's progression to diabetes; as death from infection declines, these populations age and develop other risk factors, including obesity, that can hasten the onset of diabetes and its complications.…”

“…Further, the vast majority of prior studies on dysglycemia among African populations have focused primarily on diabetes, with limited inclusion of prediabetes . Our finding of the potentially large burden of prediabetes in Namibia portends a potentially large future epidemic of diabetes, underscoring the need for Namibian health authorities to prepare to manage commonly concurrent burdens of vascular disease and kidney disease among their citizens.…”

Self-Care Practices of Preparatory School Students with Type 1 Diabetes Mellitus in ELBehira Governorate

“…Consistent findings were illustrated by Soheilipour F et al (2015), [39] as they suggested that higher mothers' awareness is positively correlated with better blood sugar control in their children which was mainly mediated by their socioeconomic status. Furthermore, Niba LL et al (2017) [40] asserted that minimal maternal involvement as a primary caregiver in self-care practices of their diabetic children were significantly associated with poor outcome.…”

Pathways of emotional autonomy, problem‐solving ability, self‐efficacy, and self‐management on the glycemic control of adolescents with type 1 diabetes: A prospective study

“…For adolescents, such management activities involve collaborating and communicating with parents and healthcare providers, setting future healthy lifestyle goals, and performing problem‐solving activities (Schilling et al, 2009). Self‐management in adolescents is challenging, and glycemic control is typically at its worst in the transitional period between adolescence and adulthood (Czenczek‐Lewandowska et al, 2019; Niba et al, 2017). One longitudinal study determined that adolescents with adaptive self‐management patterns at baseline exhibited superior glycemic control two years later compared with those in maladaptive self‐management groups (Rohan et al, 2014).…”