To Study the Impact of Sociodemographic Factors on Glycemic Control of Children with Type I Diabetes Mellitus

Sara  Ambreen; Rehmana  Wari; Muhammad  Tariq; Faiza  Qayyum; Fatima  Tuz Zahra; Rashiqa  Saadat

doi:10.54112/bcsrj.v6i2.1589

Authors

Sara Ambreen Children Hospital Pakistan Institute of Medical Sciences Islamabad, Pakistan
Rehmana Wari Children Hospital Pakistan Institute of Medical Sciences Islamabad, Pakistan
Muhammad Tariq Children Hospital Pakistan Institute of Medical Sciences Islamabad, Pakistan
Faiza Qayyum Children Hospital Pakistan Institute of Medical Sciences Islamabad, Pakistan
Fatima Tuz Zahra Children Hospital Pakistan Institute of Medical Sciences Islamabad, Pakistan
Rashiqa Saadat Children Hospital Pakistan Institute of Medical Sciences Islamabad, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i2.1589

Keywords:

Diabetes Mellitus, Type 1 Glycemic Control Caregivers Blood Glucose Monitoring Sociodemographic Factors

Abstract

Type 1 Diabetes Mellitus (T1DM) is a chronic autoimmune condition characterized by the destruction of insulin-producing beta cells in the pancreas, leading to lifelong dependence on insulin therapy. Objective: This study aims to identify the impact of sociodemographic factors on Glycemic control of children with Type 1 Diabetes Mellitus by using Sociodemographic Information. Methodology: This Cross-sectional Prospective study was conducted at a Diabetic clinic, children's Hospital, PIMS from 01/12/23 till 30/11/24. Data were collected through Non-probability consecutive sampling. Both inpatient and outpatient participants meeting the inclusion criteria were included in the study. Demographic and clinical data were collected through a structured questionnaire. Results: In comparison to older children (8–12 years), younger children (ages 1–8) showed superior glycemic control (39.6% good control), with a statistically significant difference (p = 0.001). Glycemic control was positively impacted by 98% of caregivers having either adequate or good knowledge about diabetes management. Compared to children with other caregivers, children whose mothers were their primary caregivers demonstrated improved glycemic control. Good BSR monitoring (≥3 times/day) was associated with improved glycemic control, with 49% of patients exhibiting good monitoring adherence (p = 0.001). Clinically, the mean fasting blood glucose was 195 ± 48 mg/dL, post-prandial blood glucose was 285 ± 62 mg/dL, and HbA1c averaged 9.2 ± 2.1%, indicating poor glycemic control. Conclusion: In our study, glycemic control was not significantly predicted by parental education or socioeconomic level; however, enhanced glycemic control was correlated with caregiver understanding of diabetes management. Additionally, it was discovered that maintaining ideal glycemic control required regular blood glucose checks and maternal involvement as the primary caregiver.

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References

Reid L, Baxter F, Forbes S. Effects of islet transplantation on microvascular and macrovascular complications in type 1 diabetes. Diabet Med [Internet]. 2021 Jul [cited 2022 May 13];38(7). Available from: https://onlinelibrary.wiley.com/doi/10.1111/dme.14570

Rewers M, Ludvigsson J. Environmental risk factors for type 1 diabetes. The Lancet. 2016 Jun;387(10035):2340–8.

Alassaf A, Odeh R, Gharaibeh L, Ibrahim S, Ajlouni K. Impact of Socioeconomic Characteristics on Metabolic Control in Children with Type 1 Diabetes in a Developing Country. J Clin Res Pediatr Endocrinol. 2019 Dec 1; 11(4):358–65.

Glycemic Targets: Standards of Medical Care in Diabetes—2021. Diabetes Care. 2020 Dec 4; 44(Supplement_1):S73–84. Available from: https://doi.org/10.2337/dc21-s006

Zuckerman-Levin N, Dabaja-Younis H, Ameer E, Cohen M, Maor Y, Shehadeh N. Effect of Socioeconomic Status and Ethnicity on Glycemic Control in Arab and Jewish Youth with Type 1 Diabetes Mellitus. Rambam Maimonides Med J. 2018 Oct 4; 9(4):e0030.

Noorani M, Ramaiya K, Manji K. Glycaemic control in type 1 diabetes mellitus among children and adolescents in a resource-limited setting in Dar es Salaam - Tanzania. BMC Endocr Disord. 2016 Dec; 16(1):29.

Ogugua CF, Chikani UN, Okiche CY, Ibekwe UM. Sociodemographic determinants of glycaemic control among children with type 1 diabetes in South Eastern Nigeria. Pan Afr Med J. 2021 Mar 9; 38:250. Doi: 10.11604/pamj.2021.38.250.19790. PMID: 34104298; PMCID: PMC8164434.

AlAgha MA, Majdi WM, Aljefri HM, Ali MA, Alagha AE, Elhameed IAA, et al. Effect of parents’ educational level and occupational status on child glycemic control. Journal of Patient Care [Internet]. 2017 Jan 1; 03(02). Available from: https://scholar.archive.org/work/q4nlrqjuorf4bjby2rn7rdvwjq

Ndahura NB, Munga J, Kimiywe J, Mupere E. Caregivers’ nutrition knowledge and dietary intake of Type 1 diabetic children aged 3–14 years in Uganda. Diabetes Metabolic Syndrome and Obesity [Internet]. 2021 Jan 1; Volume 14:127–37. Available from: https://doi.org/10.2147/dmso.s285979

Chowdhury S. Puberty and type 1 diabetes. Indian Journal of Endocrinology and Metabolism [Internet]. 2015 Jan 1; 19(7):51. Available from: https://doi.org/10.4103/2230-8210.155402

McLarty RP, Alloyce JP, Chitema GG, Msuya LJ. Glycemic control, associated factors, acute complications of Type 1 Diabetes Mellitus in children, adolescents and young adults in Tanzania. Endocrinology Diabetes & Metabolism [Internet]. 2020 Nov 10; 4(2). Available from: https://doi.org/10.1002/edm2.200

Archinkova M, Konstantinova M, Savova R, Iotova V, Petrova C, Kaleva N, et al. Glycaemic control among Bulgarian children and adolescents with type 1 diabetes – an impact of the social status and the educational level of the parents. Biotechnology & Biotechnological Equipment [Internet]. 2018 Jan 24;32(2):535–41. Available from: https://doi.org/10.1080/13102818.2018.1429309

Dayal D, Yadav J, Kumar R, Gupta S, Yadav A, Nanda P. Glycaemic control and factors affecting it in type 1 diabetes in children: experience from a tertiary care centre in India. Pediatric Endocrinology Diabetes and Metabolism [Internet]. 2022 Jan 1; 28(4):281–6. Available from: https://doi.org/10.5114/pedm.2022.118326

Araszkiewicz A, Zozulinska-Ziolkiewicz D, Trepinska M, Wierusz-Wysocka B. Knowledge after five-day teaching program in intensive insulin therapy performed at the onset of type 1 diabetes influence the development of late diabetic complications. Diabetes Research and Clinical Practice [Internet]. 2008 Apr 3;81(1):61–7. Available from: https://doi.org/10.1016/j.diabres.2008.02.009

Gillani S, Junaid Khan M, Abbas Z, Razzaq A, and Ahmed I, Sadaat S. Glycemic control among children with type 1 diabetes mellitus in northern areas of Pakistan. Medical Forum Monthly [Internet]. 2021 Oct; 32. Available from: https://medforum.pk/article/17glycemic-control-among-children-with-type-1-diabetes-mellitus-in-northern-areas-of-pakistan

Pihoker C, Braffett BH, Songer TJ, Herman WH, Tung M, Kuo S, et al. Diabetes care barriers, use, and health outcomes in younger adults with Type 1 and Type 2 diabetes. JAMA Network Open [Internet]. 2023 May 5; 6(5):e2312147. Available from: https://doi.org/10.1001/jamanetworkopen.2023.12147

Al-Hadhrami R, Al-Rawajfah OM, Muliira JK, Khalaf A. Glycaemic control and its associated factors among adult Omanis with type 1 diabetes mellitus: a cross-sectional survey. Expert Rev Endocrinol Metab. 2024 May; 19(3):279-285. Doi: 10.1080/17446651.2023.2295483. Epub 2023 Dec 15. PMID: 38099952.

Pironetti, R., Saha, T., Luukkaala, T., & Keskinen, P. (2023). Sociodemographic factors affecting glycaemic control in Finnish paediatric patients with type 1 diabetes. Endocrinology, Diabetes & Metabolism, 6(6), e452. https://doi.org/10.1002/edm2.452

Charalampopoulos D, Hermann JM, Svensson J, et al. Exploring variation in glycemic control across and within eight high-income countries: a cross-sectional analysis of 64,666 children and adolescents with type 1 diabetes. Diabetes Care. 2018; 41(6): 1180-1187. doi:10.2337/dc17-2271.