Diabetes in children and young adults in Waikato Province, New Zealand: outcomes of care

Abstract

Background: Diabetes is an important cause of morbidity and mortality among young people. Despite improvements in technology, maintenance of good glycaemic control is hard to achieve particularly during the teenage years.

Aims: To assess the outcomes of care in young people aged under age 26 years with diabetes living in New Zealand's Waikato District Health Board (DHB) area.

Methods: Audit of health records.

Results: Two hundred and fifty-one patients who had attended an outpatient consultation at least once in the last 3 years were identified. The mean HbA1c was 9.2% (CI 8.8-9.8). There were no gender differences. The prevalence of retinopathy was 13%, and nephropathy up to 19%. Eleven patients were taking ACE inhibitors and one person had end-stage renal failure treated with continuous ambulatory peritoneal dialysis (CAPD). Forty percent of those patients over 10 years of age had a low density lipoprotein (LDL) cholesterol level of >2.6mmol/L. All of those patients with type 2 diabetes mellitus (T2DM) were overweight, compared to 28% of those patients with type 1 diabetes mellitus (T1DM).

Conclusions: These results confirm the difficulty of achieving good glycaemic control in children and young adults. Microvascular complications are common, particularly in those of long duration. Risk factors for macrovascular disease are present from an early age, especially in those with T2DM. It is likely that these outcomes of care are typical for children and young adults with diabetes in New Zealand.