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Impact of Socioeconomic Characteristics on Metabolic Control in Children with Type 1 Diabetes in a Developing Country.

作者信息

Alassaf Abeer, Odeh Rasha, Gharaibeh Lubna, Ibrahim Sarah, Ajlouni Kamel

机构信息

University of Jordan Faculty of Medicine, Department of Pediatrics, Amman, Jordan

University of Jordan Faculty of Medicine, Department of Clinical Pharmacy, Amman, Jordan

出版信息

J Clin Res Pediatr Endocrinol. 2019 Nov 22;11(4):358-365. doi: 10.4274/jcrpe.galenos.2019.2019.0014. Epub 2019 Apr 17.


DOI:10.4274/jcrpe.galenos.2019.2019.0014
PMID:30991788
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6878341/
Abstract

OBJECTIVE: Adequate glycemic control in children with type 1 diabetes reduces the risk of future complications. Identifying factors affecting haemoglobin A1c (HbA1c) is crucial to management of metabolic control. We aimed to identify possible socioeconomic predictors of poor metabolic control this patient group in Jordan, a developing country with limited resources. METHODS: Medical charts of children with type 1 diabetes attending the pediatric endocrine clinics in two major diabetes centers were reviewed. HbA1c ≥7.5% (58 mmol/mol) was considered to reflect poor metabolic control. Logistic regression analysis was performed to identify predictors of poor glycemic control. The association between socioeconomic characteristics and metabolic control was evaluated using multiple correspondence analysis (MCA). RESULTS: Two hundred and fifty-nine children were enrolled in the study. One fifth of the patients (20.5%) achieved HbA1c <7.5%. Patients with dietary non-compliance [odds ratio (OR): 3.533, confidence interval (CI): 1.803 - 6.926; p<0.001], and those who were overweight (OR: 3.869, CI: 1.218 - 12.294; p=0.022) were more likely to have poor metabolic control. Children whose mothers had a bachelor’s degree or higher were less likely to have poor metabolic control compared to children whose mothers had only elementary education (OR: 0.241, CI: 0.079 - 0.734; p=0.012). MCA revealed an association between low socioeconomic status and poor metabolic control. Children with deceased mothers had significantly higher HbA1c of 10.6±1.86% compared to an average of 8.7±1.45% for the rest of participants (p=0.005). CONCLUSION: Low socioeconomic status, lower levels of maternal education and maternal death were associated with poor metabolic control. Identifying children with these risk factors might play an important role in optimizing metabolic control and provide better diabetes care.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7087/6878341/09db9d3da348/JCRPE-11-358-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7087/6878341/09db9d3da348/JCRPE-11-358-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7087/6878341/09db9d3da348/JCRPE-11-358-g1.jpg

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Impact of Socioeconomic Characteristics on Metabolic Control in Children with Type 1 Diabetes in a Developing Country.

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[4]
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[5]
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本文引用的文献

[1]
The role of socio-economic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: an Italian multicentre survey.

Pediatr Diabetes. 2017-5

[2]
Interventions for Diabetic Retinopathy in Type 1 Diabetes: Systematic Review and Meta-Analysis.

Am J Ophthalmol. 2015-11

[3]
Disparities in social support systems for youths with type 1 diabetes.

Clin Diabetes. 2015-4

[4]
Impact of parental socioeconomic status on excess mortality in a population-based cohort of subjects with childhood-onset type 1 diabetes.

Diabetes Care. 2015-2-20

[5]
Glycemic control, complications, and associated autoimmune diseases in children and adolescents with type 1 diabetes in Jeddah, Saudi Arabia.

Saudi Med J. 2015-1

[6]
ISPAD Clinical Practice Consensus Guidelines 2014. Assessment and monitoring of glycemic control in children and adolescents with diabetes.

Pediatr Diabetes. 2014-9

[7]
Children's glycemic control: mother's knowledge and socioeconomic status.

Glob J Health Sci. 2013-10-29

[8]
Lower A1c among adolescents with lower perceived A1c goal: a cross-sectional survey.

Int J Pediatr Endocrinol. 2013-10-24

[9]
A contrast between children and adolescents with excellent and poor control: the T1D Exchange clinic registry experience.

Pediatr Diabetes. 2013-8-19

[10]
Individual and familial factors associated with metabolic control in children with type 1 diabetes.

Pediatr Int. 2013-12

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