Sociodemographic determinants of glycaemic control among children with type 1 diabetes in South Eastern Nigeria

Abstract

Introduction diabetic complications have been identified as the major causes of morbidity and mortality in persons with type 1 diabetes mellitus (T1DM). Lack of appropriate glycaemic control is a significant risk factor for the onset and progression of long term complications of diabetes. Identifying the determinants of good glycaemic control is therefore imperative. Methods this was a cross-sectional, hospital-based study of children aged 3-18 years with T1DM. Subjects were consecutively enrolled after obtaining consent from their parents and assent from children aged ≥7 years. A questionnaire was completed recording their clinical history and sociodemographic variables. Their HbA1c was estimated and values ≤7.5% was defined as the cut-off for optimal glycaemic control. Results seventy-one children with T1DM were enrolled for the study. Thirty-eight (53.5%) of them were males. Mean age (years) was 13.7±4. Mean age at onset of diabetes was 11.6 years (range: 3-16 years), mean duration of diabetes was 24.4 months (range: 4-84 months), mean HbA1c value was 10.5% (range: 6.4%-14%); a multivariate logistic regression analysis was performed to identify determinants of optimal glycaemic control. Only caregivers' involvement in diabetes management P<0.016, odd ratio 13.03 (95% CI: 1.60-105.95) was identified as determinant of good glycaemic control. Conclusion our data suggest that of all the sociodemographic factors studied, caregivers' involvement in diabetes management was the only strong determinant for optimal glycaemic control.

Glycemic Control and Associated Factors Among Children and Adolescents with Type 1 Diabetes Mellitus, Southwest Ethiopia

“…This is in line with study done in Southeast Nigeria, on sociodemographic determinants of glycemic control among children with type 1 diabetes, and found caregivers’ involvement in diabetes management was the only strong determinant for optimal glycemic control. 8 This could be explained by some children may not take doses accurately when they take without supervision by the caregiver.…”

“…It is also consistent with the finding of study done in Sudan which showed the prevalence of poor glycemic control of 76%. [7][8][9]11,16 This similarity in glycemic control could be due to the same poor socioeconomic status in these countries as poor socioeconomic status contributes to poor glycemic control through its undesired effects on quality of diabetes care, treatment adherence, and provision of adequate and healthy nutrition. 17 According to this study regarding the nutritional status of children and adolescents with diabetes, about 22.2% were stunted.…”

“…Other diabetes related factors that were found to affect glycemic control includes duration of diabetes, adherence and involvement of caregiver in the diabetes management. [7][8][9][10][11] In a study done in Ethiopia it was found that more than fifty percent of children and adolescents with diabetes had poor glycemic control. However, in that study the HbA1c cutoff used for defining poor glycemic control was >10% (86mmol/mol) which is higher than the recommended target HbA1c; and the study did not identify factors associated with glycemic control.…”

“…determinant for optimal glycemic control. 8 This could be explained by some children may not take doses accurately when they take without supervision by the caregiver. In this study, poor blood glucose monitoring adherence was associated with poor glycemic control.…”