Department of Pediatrics, University of Jordan, Amman, Jordan.
Pharmacological and Diagnostic Research Center, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan.
Pediatr Diabetes. 2022 Sep;23(6):729-735. doi: 10.1111/pedi.13342. Epub 2022 Apr 20.
Identifying risk factors for suboptimal glycemic control during the first year after diagnosis with type 1 diabetes (T1D) may provide early appropriate and individualized management. Our aim was to study possible predictors of early glycemic control during the first year after diagnosis with T1D in children and adolescents in Jordan. This is a retrospective study conducted through a review of medical records at Jordan University Hospital and the National Centre for Diabetes, Endocrinology and Genetics. Children and adolescents diagnosed with T1D at age younger than 16 years and with diabetes duration of at least 2 years were included. Demographic, clinical and socioeconomic factors were collected, in addition to glycosylated hemoglobin (HbA1c) values during the first year after diagnosis. Average age at diagnosis of the 337 patients who were enrolled in the study was 7.7 ± 3.8 years. HbA1c at diagnosis was 10.9 ± 1.9% (95.64 ± 20.76 mmol/mol). Factors such as the involvement of children's mothers in deciding insulin doses, higher mother's educational level and higher family monthly income were associated with better early glycemic control. HbA1c at 6 months after diagnosis, parental marital status and compliance to counting carbohydrates were significant predictors of glycemic control at 12 months after diagnosis. Many clinical and socioeconomic factors were associated with early glycemic control at 12 months after diagnosis. Modifiable risk factors must be addressed as early as possible to decrease future complications. Children with nonmodifiable risk factors should be identified early for closer observation and providing individualized diabetes care plan.
确定 1 型糖尿病(T1D)诊断后第一年血糖控制不佳的风险因素,可能有助于进行早期适当的个体化管理。我们的目的是研究约旦儿童和青少年 T1D 诊断后第一年早期血糖控制的可能预测因素。这是一项回顾性研究,通过审查约旦大学医院和国家糖尿病、内分泌学和遗传学中心的病历进行。纳入年龄小于 16 岁且糖尿病病程至少 2 年的 T1D 患儿。收集了人口统计学、临床和社会经济因素,以及诊断后第一年的糖化血红蛋白(HbA1c)值。纳入研究的 337 名患者的平均诊断年龄为 7.7±3.8 岁。诊断时的 HbA1c 为 10.9±1.9%(95.64±20.76mmol/mol)。患儿母亲参与决定胰岛素剂量、母亲受教育程度较高和家庭月收入较高等因素与早期血糖控制较好相关。诊断后 6 个月的 HbA1c、父母婚姻状况和碳水化合物计数依从性是诊断后 12 个月血糖控制的显著预测因素。许多临床和社会经济因素与诊断后 12 个月的早期血糖控制相关。必须尽早解决可改变的危险因素,以减少未来的并发症。对于不可改变的危险因素的患儿,应尽早识别,以便进行更密切的观察和提供个体化的糖尿病护理计划。
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