Introduction: More than 1,106,500 worldwide children were living with type1 diabetes mellitus (T1DM) in 20171. Researchers concluded that better glycaemic control is associating with lesser complications of this chronic condition. Target HbA1c is recommended to be <48mmol/mol(<6.5%) and <53mmol/mol(<7%) as per NICE and ISPAD respectively2. The glycaemic control represented by HbA1c was worse amongst the British girls3, similar to boys in recent Saudi study4, our neighbouring country, but it was unexpectedly poorer in Omani boys compared to girls.
Aim: To examine the HbA1c in our cohort of patients and to identify the role of gender factor on glycaemic control.
Methods: Retrospective 1 year (2018 only) observational study was carried out. Data were captured from the electronic medical records of children and young people up to the age of 17 years under the care of paediatric endocrinologists at Sultan Qaboos University Hospital.
Results: 162 patients (F=89) with T1DM. Age at diagnosis ranged from 1.1 to 13.9 years, median of 6.9 years. Majority of them 145(89.5%) were on multiple daily injections regimen (MDI).
Higher HbA1c values were witnessed in teenagers. However, there was no correlation between mean HbA1c and duration of diabetes.
Interestingly, the median HbA1c amongst teenager boys was much higher than of females, 76 mmol/mol (9.2%) compared to 69mmol/mol (8.5%).
We have learnt that boys, especially in bigger Omani families, are getting somehow early independence in looking after themselves which leading to less supervision from parents resulting in poorer glycaemic control.
Conclusion: It is important to take the cultural factor in consideration when looking after children and young people with T1DM. Extra attention and support to be provided for the growing young males. We would recommend examining this observation in other Arab countries who share the same traditions with Omanis.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology