Personal and Clinical Predictors of Poor Metabolic Control in Children with Type 1 Diabetes in Jordan.

BACKGROUND

Achieving adequate metabolic control in children with type 1 diabetes is important in slowing the progression of future microvascular and macrovascular complications, but still it is a universal challenge. We aim to investigate possible factors associated with poor metabolic outcomes in Jordan as an example of a country with limited resources.

METHODS

This is a retrospective chart review study of children with type 1 diabetes. Several clinical and personal characteristics were tested for association with metabolic control reflected by HbA1c levels. Linear logistic regression analysis was used to evaluate possible predictors of metabolic control. One-way ANOVA analysis was used to detect significant differences in HbA1c between categories.

RESULTS

Significant predictors of metabolic control were found. A one-year increase in age led to an increase in HbA1c by 0.053% ( = 0.044). A decline in HbA1c levels was predicted in children who have precise amount of carbohydrates or who are receiving insulin at school (-0.46% ( = 0.014) and -0.82% ( = 0.004), respectively). When family members other than mothers decided the insulin dose, the HbA1c level increased by 0.74% ( = 0.005).

CONCLUSION

Poor metabolic control was associated with age, dietary noncompliance, not receiving insulin at school, and absence of direct mother care. Our study is one of the few studies from Middle East evaluating predictors of metabolic control. Global research studies help in giving universal insight towards developing more effective multidisciplinary team approach for diabetes care and education.