Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 65 5 2026 07 06 271 280 Elham Maleki Department of Pediatrics, Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran Mina Sepehran Department of Pediatrics, Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran Sa’adat Barkhori Mehni Department of Neurosurgery, School of Medicine, Mashhad University of Medical Sciences, Kerman, Iran. 2025 10 26 2026 02 24 Several factors have been reported to affect glycemic control, the significance of most of which is still a topic of discussion. Therefore, we aimed to investigate such effects in more detail. We conducted our cross-sectional analysis on 163 children and adolescents 2 to 18 with T1DM. Moreover, we obtained their demographic and clinical information in addition to glycated hemoglobin (HbA1C) levels and performed a multivariate regression analysis to determine their effects. Among the investigated factors parents living together (P<0.001), higher parental education (P<0.001), level of monthly income (P<0.001), and residing in urban areas (P<0.001), positive history of hospitalization due to ketoacidosis (P=0.001), injection site lipodystrophy (P=0.005), physical activity (P<0.001), regular endocrinology clinic visits (P<0.01), physician long distance access (P<0.001), social media usage (P<0.001), nutritionist supervision (P<0.001), regular visits by a mental health expert (P=0.02), body mass index (P=0.449, P<0.001), daily insulin units (r=0.447, P<0.001), height Z score (r= -0.177, P=0.024), and duration of Diabetes (r= -0.199, P=0.011) significantly affected HbA1C levels. Furthermore, the regression model significantly predicted 56.4% of the changes in HbA1C. With environmental and family-related factors proving pivotal, educational interventions and implementing relevant policies are crucial. Financial aid to those affected by facilitating access to healthcare-related technologies and state-of-the-art care centers can also pay substantial dividends. https://acta.tums.ac.ir/index.php/acta/article/view/11861 https://acta.tums.ac.ir/index.php/acta/article/download/11861/6049