Glycemic control, associated factors, acute complications of Type 1 Diabetes Mellitus in children, adolescents and young adults in Tanzania

Abstract

Objective: To determine the factors associated with poor glycemic control in children (1-10 years), adolescents (11-18 years) and young adults (19-40 years) with Type 1 Diabetes Mellitus (T1DM) in Kilimanjaro Christian Medical Center (KCMC) in Moshi, Mount Meru Regional Referral Hospital (MMRRH) and Meru District Hospital (MDH) in Arusha, Tanzania.

Methods: Cross sectional study of 150 participants conducted from January to June 2019, data was collected by structured questionnaire and analyzed using SPSS version 23.

Results: The mean HbA1c was 12.3 ± 2.2%, 146 had poor glycemic control (HbA1c > 7.5%). BMI, insulin regime and caretaker education were associated with poor glycemic control. There were 16 participants diagnosed in DKA and the most frequently reported complications in the prior 3 months were hyperglycemia (n = 25), DKA (n = 18) and hypoglycemia (n = 4).

Conclusions: Glycemic control is still very poor particularly in adolescents. Significant associations with glycemic control were higher BMI, insulin regime and guardian education. The study revealed lower prevalence of DKA at diagnosis compared to previous studies.

Keywords: acute complications; associated factors; glycemic control.

FIGURE 1

Flow chart of the participants. A total of 432 presented to study sites during the study period, a total of 274 not interviewed, most (N = 146) had poor glycemic control and only 4 presented with good glycemic control

FIGURE 2

The acute complications in T1DM among participants. (N = 150), acute complications were as reported in the last 3 months. Only absolute numbers are reported

FIGURE 3

Acute complications related to T1DM by age group of the study participant. (N = 150), Complications were as reported in the last 3 months, only absolute numbers are reported