Meseret Fentahun, Masrie Awoke, Weldesenbet Adisu Birhanu, Aynalem Zewdu Bishaw, Abate Melsew Dagne, Muhamed Ahmed Nuru, Abebe Gebremeskel Kibret
Department of Pediatrics and Child Health Nursing, School of Nursing, College of Health and Medical Science, Haramaya University, Harar, Ethiopia.
School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
BMC Public Health. 2025 Aug 11;25(1):2729. doi: 10.1186/s12889-025-23734-9.
Poor glycemic control increases the risk of acute metabolic derangements and long-term consequences, which are the main causes of morbidity and mortality. Sustaining optimal glycemic control is challenging for children with diabetes, mainly in resource-limited settings. Numerous factors have identified as being associated with poor glycemic control among type 1 diabetic children. However, studies scrutinizing about the magnitude of poor glycemic control have had inconsistent findings in Ethiopia. This systematic review and meta-analysis is therefore aimed at appraising the pooled prevalence of poor glycemic control and its associated factors among type 1 diabetic children in Ethiopia by combining the studies from the existing literatures.
All relevant articles published between December 30, 2015 and June 1, 2024, were systematically retrieved from scientific databases (PubMed, Hinari, Scopus, web of science, Science direct and Google scholar). Stata version 17 was used to analyze data (poor glycemic control and factors associated). From the identified studies, the one that shows the association of poor glycemic control and having glucometer were included. I2 tests were used to assess the heterogeneity of the studies. Subgroup analysis was done based on sample sizes and year of publication to determine how pooled estimates of poor glycemic control vary across the studies events. The pooled estimate of association between poor glycemic control and having glucometer as glucose level monitoring equipment/device was reported.
The aggregated seven articles revealed a lower odds of glycemic control among type 1 diabetic patients with no having glucometer as glucose level monitoring device than those who had it (POR: 0.51, 95% CI: 0.08, 0.93). The pooled prevalence of poor glycemic control among type 1 diabetic children in Ethiopia was 71% (95%: CI: 57, 85); (I2 = 97:57%, P < 0.01). Subgroup analysis was performed based on sample size, and the highest pooled prevalence (76%) was observed among primary studies with sample sizes less than 200.
The pooled prevalence of poor glycemic control among type 1 diabetic children was high in Ethiopia. Access of glucometer as glucose monitoring was fond to be the significant factor for glycemic control. Therefore, we recommend ministry of health and other stack holders to increase the accessibility of glucometer for all diabetic children in Ethiopia.
血糖控制不佳会增加急性代谢紊乱和长期后果的风险，而这些是发病和死亡的主要原因。对糖尿病患儿来说，维持最佳血糖控制具有挑战性，在资源有限的环境中更是如此。已确定许多因素与1型糖尿病患儿血糖控制不佳有关。然而，在埃塞俄比亚，关于血糖控制不佳程度的研究结果并不一致。因此，本系统评价和荟萃分析旨在通过整合现有文献中的研究，评估埃塞俄比亚1型糖尿病患儿血糖控制不佳的合并患病率及其相关因素。
从科学数据库（PubMed、Hinari、Scopus、科学网、Science direct和谷歌学术）中系统检索2015年12月30日至2024年6月1日期间发表的所有相关文章。使用Stata 17版软件分析数据（血糖控制不佳及相关因素）。从已识别的研究中，纳入显示血糖控制不佳与拥有血糖仪之间关联的研究。使用I²检验评估研究的异质性。基于样本量和发表年份进行亚组分析，以确定血糖控制不佳的合并估计值在不同研究事件中的差异情况。报告了血糖控制不佳与拥有血糖仪作为血糖水平监测设备之间关联的合并估计值。
汇总的七篇文章显示，在没有血糖仪作为血糖水平监测设备的1型糖尿病患者中，血糖控制达标的几率低于拥有血糖仪的患者（比值比：0.51，95%置信区间：0.08，0.93）。埃塞俄比亚1型糖尿病患儿血糖控制不佳的合并患病率为71%（95%：置信区间：57，85）；（I² = 97.57%，P < 0.01）。基于样本量进行亚组分析，在样本量小于200的初步研究中观察到最高的合并患病率（76%）。
埃塞俄比亚1型糖尿病患儿血糖控制不佳的合并患病率较高。拥有血糖仪作为血糖监测手段被认为是血糖控制的重要因素。因此，我们建议卫生部和其他利益相关者提高埃塞俄比亚所有糖尿病患儿获得血糖仪的可及性。
