ESPE Abstracts

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: 0.02–0.2), being on two daily injection (OR: 0.2, 95% CI; 0.1–0.5) and good blood glucose monitoring (BGM) adherence (OR: 0.1, 95% CI: 0.04–0.3) were significantly (P<0.001) associated to good outcome as indicated by HbA1c, while older age (OR: 1.1, 95% CI: 0.4–3.2) and longer diabetes duration (OR: 0.9, 95% CI: 0.3–2.9) were not (P>0.05). Minimal/moderate caregiver involvement in BGM (OR: 7.7, 95% CI: 2.7–22.0) and insulin injection (OR: 14.9, 95% CI: 4.8–46.5) 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: 0.002–0.189) was an independent predictor of good outcome.

Conclusion: This study confirms that mother’s involvement in the diabetes management of their children is the most important determinant for treatment outcome.