Factors associated with glycemic control in children with type 1 diabetes mellitus.

Type I diabetes mellitus is a chronic metabolic disorder with heterogeneous etiologies characterized by hyperglycemia as a cardinal biochemical feature. Patients with Diabetes mellitus are at increased risk of morbidity and mortality due to the micro and macrovascular complication caused by diabetes. Maintaining strict glycemic control in type I DM reduces the incidence and progression of long term complication. There are various risk factors found to be associated with poor glycemic control. Identification of risk factors associated with poor glycemic control is necessary, so that appropriate intervention can be done to improve glycemic control and to prevent complication. As there is a lack of regional literature, this study was undertaken in our setting. Aims and Objectives To study the factors associated of glycemic control in Type I Diabetes Children. Materials and Methods This is a cross sectional study carried out at the diabetes clinic for children at tertiary care hospital ICH & HC in Chennai. Children attending the clinic were enrolled into the study after obtaining informed consent from the parent / guardian. A structured questionnaire was used to collect date from the parents/guardian. Glycemic Control was assessed by measurement of glycosylated Hb .Data entry and analysis was done using Epi Info Software Version 3.5.1 and SPSS version 16. Results 99 participants were recruited into the study. The mean HbA1C was 9.16% (SD2.168) came under a fair control group. 31 children had age appropriate glycemic control. The children with good glycemic control had a statistically significant level of hypoglycemic p=0.041. 53 children presented with DKA as initial onset of diabetes mellitus. 21 children were hospitalized for inter current illness. Conclusion The following factors namely age, duration of diabetes, insulin regimen, SMBG, compliance to therapy, follow up and serum cholesterol did not have impact on glycemic control. Hypo glycemic episodes were found to be more common in children with good glycemic control which was statistically significant