Background: Type 1 diabetes mellitus (T1DM) is one of the most frequent chronic diseases in childhood and adolescence. Poor metabolic control is associated with numerous and onerous consequences. HbA1c levels are important in the assessment and monitoring of metabolic control in T1DM. Therefore, it is essential to know the causes of its variability.
Objective and hypotheses: Determine the impact of age and time of disease in the value of HbA1c in children and adolescents with T1DM, as well as appreciate the relationship between HbA1c/dyslipidemia and HbA1c/microalbuminuria.
Method: We designed an observational, transversal, and retrospective analysis of the files of a pediatric population with T1DM followed in a Pediatric Diabetic Consult in a Tertiary Hospital in Portugal. The studied variables were: gender, age, age at diagnosis, metabolic control and metabolic complications.
Results: Our population consisted of 104 T1DM patients (47.1% female, and 52.9% male). The HbA1c mean value in the last year was 7.8% (<7.5% in 43.3%). We realized that adolescents HbA1c was not higher than in children (7.8 vs 7.9%). Patients with T1DM duration of disease higher than 5 years had greater HbA1c values (8 vs 7.7%). 13.5% (n=14) of patients had microalbuminuria and 12.5% (n=13) had dyslipidemia. Besides, those with microalbuminuria did not had higher values of HbA1c (7.7 vs 7.9%) and the values were not significantly different in patients with or without dyslipidemia (7.8 vs 7.9%).
Conclusion: In this study, we confirmed that patients with longer diabetes duration had the highest HbA1c values. We also verified that the consequences of a poor metabolic control, like microalbuminuria and dyslipidemia, can occur even at pediatric age.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology