Background: In Sub-Saharan Africa the prognosis of children with type 1 diabetes is poor. Many are not diagnosed and those diagnosed have a dramatically reduced life expectancy (<1 year).
Objective and hypotheses: To identify the predictors of outcome in children and adolescents with type 1 diabetes.
Method: A cross sectional study involving 76 children/adolescents (35 boys and 41 girls, mean age of 15.1±3.1 years) with type 1 diabetes included in the changing diabetes in children (CDiC) programme and attending the clinics for children living with type 1 diabetes in the North West Region of Cameroon. Data on glycosylated haemoglobin (HbA1c) was obtained from hospital records of participants. Socio-demographic characteristics and diabetes related practices were obtained from participants using a structured questionnaire. Odds ratios (OR) were calculated using logistic regression models to assess the association between determinants and good glycaemic control.
Results: The study population had a mean HbA1c of 10.3±2.9%. Univariate analysis indicated that having a mother as the primary caregiver (OR: 0.07, 95% CI: 0.020.2), being on two daily injection (OR: 0.2, 95% CI; 0.10.5) and good blood glucose monitoring (BGM) adherence (OR: 0.1, 95% CI: 0.040.3) were significantly (P<0.001) associated to good outcome as indicated by HbA1c, while older age (OR: 1.1, 95% CI: 0.43.2) and longer diabetes duration (OR: 0.9, 95% CI: 0.32.9) were not (P>0.05). Minimal/moderate caregiver involvement in BGM (OR: 7.7, 95% CI: 2.722.0) and insulin injection (OR: 14.9, 95% CI: 4.846.5) were significantly (P<0.001) associated to poor outcome. Multivariate analysis showed that having a mother as the primary caregiver (OR: 0.02, 95% CI: 0.0020.189) was an independent predictor of good outcome.
Conclusion: This study confirms that mothers involvement in the diabetes management of their children is the most important determinant for treatment outcome.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology