Predictors of Glucose Control in Children and Adolescents with Type 1 Diabetes: Results of a Cross‑Sectional Study in Khartoum, Sudan

Authors

  • Zainab Taha Department of Health Sciences, Zayed University, Abu Dhabi
  • Zeinab Eltoum School of Health Sciences, Ahfad University for Women, Omdurman
  • Sidiga Washi School of Health Sciences, Ahfad University for Women, Omdurman

DOI:

https://doi.org/10.3889/oamjms.2018.423

Keywords:

Diabetes mellitus, Glycemic control, Children, Adolescents, Sudan.

Abstract

BACKGROUND: Type 1 diabetes mellitus (T1DM) is a rapidly growing problem in Sudan as well as other African countries. Children and adolescents with type 1 diabetes have previously been found to have poor glycemic control. Strict glycemic control reduces the incidence and progression of chronic complications.

AIM: This study aimed to identify the factors associated with glycemic control among children and adolescents.

METHODS: The study was a health-centre based descriptive cross-sectional study. Data on socioeconomic, demographic, disease history, and diabetes-specific variables was obtained. Glycemic control was assessed by measuring glycosylated haemoglobin (HbA1C). Linear regression analysis was done to determine factors associated with glycemic control.

RESULTS: One hundred Sudanese children with T1DM aged from (1-18) years were recruited for the study (63 % females). Most of the study children (80%) had high random blood glucose levels. Less than half (40%) suffered from the presence of glucose in their urine and one-quarter of them have urine ketones. Also, Glycosylated haemoglobin (HbA1c) level of the study children showed that more than three-quarters (76%) had poor glycemic control. It was found that there is no relationship between nutritional status and glycemic control. However, there is a relationship between socioeconomic status and glycemic control (P = 0.025)

CONCLUSION: To improve metabolic control, more frequent BGM should be encouraged among children and adolescents with T1DM. Emphasis needs to be put on providing families with children with diabetes with the medical, financial and social support for better control of their diabetes.

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References

Noble JA, Erlich HA. Genetics of type 1 diabetes. Cold Spring Harbor perspectives in medicine. 2012; 2(1):a007732. https://doi.org/10.1101/cshperspect.a007732PMid:22315720 PMCid:PMC3253030

Steck AK, Rewers MJ. Genetics of type 1 diabetes. Clinical chemistry. 2011; 57(2):176-85. https://doi.org/10.1373/clinchem.2010.148221 PMid:21205883 PMCid:PMC4874193

Marigliano M, Tadiotto E, Morandi A, Sabbion A, Contreas G, Avossa F, et al. Epidemiology of type 1 diabetes mellitus in the pediatric population in Veneto Region, Italy. Diabetes research and clinical practice. 2015; 107(3):e19-21. https://doi.org/10.1016/j.diabres.2014.12.009 PMid:25641011

Ogurtsova K, da Rocha Fernandes JD, Huang Y, Linnenkamp U, Guariguata L, Cho NH, et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes research and clinical practice. 2017; 128:40-50. https://doi.org/10.1016/j.diabres.2017.03.024 PMid:28437734

Dabelea D, Bell RA, D'Agostino RB, Jr., Imperatore G, Johansen JM, Linder B, et al. Incidence of diabetes in youth in the United States. Jama. 2007; 297(24):2716-24. https://doi.org/10.1001/jama.297.24.2716 PMid:17595272

Vehik K, Hamman RF, Lezotte D, Norris JM, Klingensmith G, Bloch C, et al. Increasing incidence of type 1 diabetes in 0- to 17-year-old Colorado youth. Diabetes care. 2007; 30(3):503-9. https://doi.org/10.2337/dc06-1837 PMid:17327312

Noor SK, Elmadhoun WM, Bushara SO, Almobarak AO, Salim RS, Forawi SA, Awadallah H, Elwali ES, Ahmed MH. Glycaemic control in Sudanese individuals with type 2 diabetes: Population based study. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2017; 11:S147-51. https://doi.org/10.1016/j.dsx.2016.12.024 PMid:28034691

Majaliwa ES, Elusiyan BE, Adesiyun OO, Laigong P, Adeniran AK, Kandi CM, et al. Type 1 diabetes mellitus in the African population: epidemiology and management challenges. Acta bio-medica : Atenei Parmensis. 2008;79(3):255-9.

Elamin A, Ghalib M, Eltayeb B, Tuvemo T. High incidence of type 1 diabetes mellitus in Sudanese children, 1991-1995. Ann Saudi Med. 1997; 17(4):478-80. https://doi.org/10.5144/0256-4947.1997.478 PMid:17353609

Patterson C, Guariguata L, Dahlquist G, Soltesz G, Ogle G, Silink M. Diabetes in the young - a global view and worldwide estimates of numbers of children with type 1 diabetes. Diabetes research and clinical practice. 2014; 103(2):161-75. https://doi.org/10.1016/j.diabres.2013.11.005 PMid:24331235

Danne T, Kordonouri O, Enders I, Weber B. Factors influencing height and weight development in children with diabetes. Results of the Berlin Retinopathy Study. Diabetes care. 1997; 20(3):281-5. https://doi.org/10.2337/diacare.20.3.281 PMid:9051372

Demir K, Altincik A, Abaci A, Buyukgebiz A, Bober E. Growth of children with type 1 diabetes mellitus. Journal of clinical research in pediatric endocrinology. 2010; 2(2):72-7. https://doi.org/10.4274/jcrpe.v2i2.72 PMid:21274342 PMCid:PMC3005675

Marcovecchio ML, Heywood JJ, Dalton RN, Dunger DB. The contribution of glycemic control to impaired growth during puberty in young people with type 1 diabetes and microalbuminuria. Pediatric diabetes. 2014; 15(4):303-8. https://doi.org/10.1111/pedi.12090 PMid:24320564

Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L, et al. Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes care. 2005; 28(1):186-212. https://doi.org/10.2337/diacare.28.1.186 PMid:15616254

Elrayah H, Eltom M, Bedri A, Belal A, Rosling H, Ostenson CG. Economic burden on families of childhood type 1 diabetes in urban Sudan. Diabetes research and clinical practice. 2005; 70(2):159-65. https://doi.org/10.1016/j.diabres.2005.03.034 PMid:15919129

Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial. Diabetes Control and Complications Trial Research Group. The Journal of pediatrics. 1994; 125(2):177-88. https://doi.org/10.1016/S0022-3476(94)70190-3

15. Diabetes Advocacy: Standards of Medical Care in Diabetes-2018. Diabetes care. 2018; 41(Suppl 1):S152-s3. https://doi.org/10.2337/dc18-S015 PMid:29222386

Eliadarous H. Exploring the impact of diabetes in Sudan:Out-of-pocket expenditure and social consequences of diabetes on patients and their familie. Stockholm, Sweden. : Karolinska Institutet; 2017.

Rosilio M, Cotton JB, Wieliczko MC, Gendrault B, Carel JC, Couvaras O, et al. Factors associated with glycemic control. A cross-sectional nationwide study in 2,579 French children with type 1 diabetes. The French Pediatric Diabetes Group. Diabetes care. 1998; 21(7):1146-53. https://doi.org/10.2337/diacare.21.7.1146 PMid:9653610

Araujo MB, Mazza CS. Assessment of risk factors of poor metabolic control in type 1 diabetic children assisted in a public hospital in Argentina. Pediatric diabetes. 2008; 9(5):480-7. https://doi.org/10.1111/j.1399-5448.2008.00388.x PMid:18761645

Hood KK, Peterson CM, Rohan JM, Drotar D. Association between adherence and glycemic control in pediatric type 1 diabetes: a meta-analysis. Pediatrics. 2009; 124(6):e1171-9. https://doi.org/10.1542/peds.2009-0207 PMid:19884476

Anderson B, Ho J, Brackett J, Finkelstein D, Laffel L. Parental involvement in diabetes management tasks: relationships to blood glucose monitoring adherence and metabolic control in young adolescents with insulin-dependent diabetes mellitus. The Journal of pediatrics. 1997; 130(2):257-65. https://doi.org/10.1016/S0022-3476(97)70352-4

World Health Organization. (WHO). (2007). Child Growth Reference 0-19 years. https://play.google.com/store/apps/details?id=com.LetsStart.GrowthChart.

WHOW. Global report on diabetes. 2016;World Health Organization 2016.

L. Kathleen Mahan MS RD CDE JLRMRC, Sylvia Escott-Stump MA RD LDN Krause's food & the nutrition care process. (13th ed.) ed: Elsevier, 2012.

Icks A, Rosenbauer J, Holl RW, Grabert M, Rathmann W, Giani G. Hospitalization among diabetic children and adolescents and the general population in Germany. German Working Group for Pediatric Diabetology. Diabetes care. 2001; 24(3):435-40. https://doi.org/10.2337/diacare.24.3.435 PMid:11289464

L. Kathleen Mahan JLR. Krause's Food & the Nutrition Care Process (Krause's Food & Nutrition Therapy) Elsevier; 2017.

Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2018. Diabetes care. 2018; 41(Suppl 1):S13-s27. https://doi.org/10.2337/dc18-S002 PMid:29222373

Foundations of care: education, nutrition, physical activity, smoking cessation, psychosocial care, and immunization. Diabetes care. 2015; 38(Suppl):S20-30. https://doi.org/10.2337/dc15-S007 PMid:25537702

Ngwiri T, Were F, Predieri B, Ngugi P, Iughetti L. Glycemic Control in Kenyan Children and Adolescents with Type 1 Diabetes Mellitus. International journal of endocrinology. 2015; 2015:761759. https://doi.org/10.1155/2015/761759 PMid:26494998 PMCid:PMC4606130

Noorani M, Ramaiya K, Manji K. Glycaemic control in type 1 diabetes mellitus among children and adolescents in a resource limited setting in Dar es Salaam - Tanzania. BMC endocrine disorders. 2016; 16(1):29. https://doi.org/10.1186/s12902-016-0113-y PMid:27246505 PMCid:PMC4886407

Giannini C, Mohn A, Chiarelli F. Growth abnormalities in children with type 1 diabetes, juvenile chronic arthritis, and asthma. International journal of endocrinology. 2014; 2014:265954. https://doi.org/10.1155/2014/265954 PMid:24648838 PMCid:PMC3932221

Published

2018-11-09

How to Cite

1.
Taha Z, Eltoum Z, Washi S. Predictors of Glucose Control in Children and Adolescents with Type 1 Diabetes: Results of a Cross‑Sectional Study in Khartoum, Sudan. Open Access Maced J Med Sci [Internet]. 2018 Nov. 9 [cited 2024 Mar. 29];6(11):2035-9. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2018.423

Issue

Section

B - Clinical Sciences

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