Abrahim Aneso Mohammed, Tilahun Tsion, Gelana Beshea
Department of Pediatrics and Child Health, Jimma University, Jimma, Ethiopia.
Department of Health Policy and Management, Jimma University, Jimma, Ethiopia.
Diabetes Metab Syndr Obes. 2023 Jul 4;16:2025-2037. doi: 10.2147/DMSO.S412529. eCollection 2023.
Type 1 diabetes mellitus is the most common endocrine disorder among children and adolescents worldwide. Glycemic control is the ultimate goal of management of diabetes. Poor glycemic control is shown to be associated with complications of diabetes. Only a few studies have addressed the problem in Ethiopia, and this study aimed to determine the level of glycemic control and factors associated among children and adolescents with type 1 diabetes mellitus on follow up.
Institution based cross sectional study design was conducted on a total of 158 children and adolescents with type 1 diabetes on follow up at Jimma Medical Center from July to October 2022. Data were collected using structured questionnaire and entered into Epi Data 3.1 then exported to SPSS for analysis. Glycemic control was assessed based on glycosylated hemoglobin (HbA1c) level. Descriptive and inferential statistics were employed, and a p-value <0.05 was considered to declare statistical significance.
The mean glycosylated hemoglobin of the participants was 9.67 ± 2.28%. Of the total study participants, 121 (76.6%) had poor glycemic control. In multivariable logistic regression, guardian or father as a primary caregiver [guardian (AOR=4.45, 95%, p=0.045), father (AOR=6.02, 95%, p=0.023)], minimal involvement of caregiver in insulin injection (AOR=5.39, 95%, p=0.002), poor blood glucose monitoring adherence (AOR=4.42, 95%, p=0.026), faced problems at health facility (AOR=4.42, 95%, p=0.018) and being admitted to hospital in the past 6 months (AOR=7.94, 95%, p=0.004) were the variables significantly associated with poor glycemic control.
Majority of children and adolescents with diabetes had poor glycemic control. Whereas, primary caregiver other than mother, minimal involvement of caregiver in insulin injection, and poor adherence to glucose monitoring were among the contributing factors for poor glycemic control. Therefore, adherence counseling and the participation of caregivers in diabetes management is recommended.
1型糖尿病是全球儿童和青少年中最常见的内分泌疾病。血糖控制是糖尿病管理的最终目标。血糖控制不佳与糖尿病并发症相关。在埃塞俄比亚，仅有少数研究涉及该问题，本研究旨在确定1型糖尿病儿童和青少年随访期间的血糖控制水平及相关因素。
2022年7月至10月，在吉姆马医疗中心对158名接受随访的1型糖尿病儿童和青少年进行了基于机构的横断面研究设计。使用结构化问卷收集数据，录入Epi Data 3.1，然后导出到SPSS进行分析。根据糖化血红蛋白（HbA1c）水平评估血糖控制情况。采用描述性和推断性统计方法，p值<0.05被认为具有统计学意义。
参与者的平均糖化血红蛋白为9.67±2.28%。在所有研究参与者中，121人（76.6%）血糖控制不佳。在多变量逻辑回归中，作为主要照顾者的监护人或父亲[监护人（比值比=4.45，95%，p=0.045），父亲（比值比=6.02，95%，p=0.023）]、照顾者极少参与胰岛素注射（比值比=5.39，95%，p=0.002）、血糖监测依从性差（比值比=4.42，95%，p=0.026）、在医疗机构遇到问题（比值比=4.42，95%，p=0.018）以及在过去6个月内住院（比值比=7.94，95%，p=0.004）是与血糖控制不佳显著相关的变量。
大多数糖尿病儿童和青少年血糖控制不佳。而母亲以外的主要照顾者、照顾者极少参与胰岛素注射以及血糖监测依从性差是血糖控制不佳的促成因素。因此，建议进行依从性咨询并让照顾者参与糖尿病管理。
