Glycosylated Hemoglobin and Related Factors in Children With Type 1 Diabetes Mellitus Under 20 Years of Age

Abstract

The number of child and adolescence with type 1 diabetes mellitus (T1DM) is increasing. This study was conducted to assess glycemic control in child and adolescence with type 1 diabetes mellitus and its associated factors in Hamadan (Iran). This was a prospective observational study, dealing with 110 child and adolescence with type 1 diabetes mellitus, who referred to a pediatric diabetes clinic, affiliated to Hamadan University of Medical Sciences in 2012-2014. All blood tests were performed in a single laboratory. In this study, HbA1c levels of 6-7.9%, 8-9.9 and >10% were considered as good, moderate, and poor control. All collected data were recorded in the questionnaire. The number of male and female was equal. HbA1c level was equal to 6-7.9 in 48 patients (43.6%), 8-9.9 in 38 patients (34.5%), and more than 10 in 24 individuals (21.8%). Poor glycemic control was associated with: older age, duration of disease more than 5 years, less glucose monitoring, greater insulin dose, illiterate mothers, and more number of children, and residency in rural regions. Moreover, intensive insulin regimen and more times of insulin injection increased HbA1c level, though the difference was not significant. We concluded that in T1DM child and adolescence, the age, long duration of disease, number of glycemic control, insulin dose and living in urban regions are effective factors on the better control of the HbA1c levels. To improve glycemic control, we suggest more education and social support especially for mothers and rural patients and more blood glucose monitoring.