Ricardo Rodrigues1, Isabela Cristina Borges Rossi2, Bruno Franco Rossi3, Débora Cristiane Gomes4, Nilson Penha-Silva5. 1. Hospital de Clínicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil. Electronic address: ricardo.rodrigues@ufu.br. 2. Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil. 3. Centro Universitário IMEPAC, Araguari, MG, Brazil. 4. Hospital de Clínicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil. 5. Instituto de Biotecnologia, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.
Abstract
INTRODUCTION: This study evaluated the demographic, clinical, and laboratory data - including traditional (as glycated hemoglobin, HbA1c) and new glycemic metrics (as time in range, TiR) - and the complications present in children and adolescents (CA) in outpatient follow-up, as well as their possible associations. METHODS: This retrospective observational study's data were compiled from the CA's medical records with T1DM (n = 78) being followed up at the Pediatric Endocrinology Service of the Federal University of Uberlândia. RESULTS: The average participants' age was 10.2 years (1-16), most of them (55%) being male, with a diagnosis time of 4.5 years (1-13), and a body mass index of 18 kg/m2. The group had HbA1c levels of 9.6% and an estimated average glycemia of 229.5 ± 103 mg/dL. TiR was 25% (7-54%); the short- (CV%) and medium-term (ΔHbA1c) glycemic variability was 45.7% and 1.5%, respectively. Approximately 10% had diabetes ketoacidosis in the last year of follow-up, about 6% had chronic complications, such as nephropathy or retinopathy, and 20% had some other associated autoimmune disease. 49% of the participants reported regular physical activity. CONCLUSION: The high values of HbA1c and glycemic variability amplitude, short TiR, and the early presence of chronic complications reveal that the treatment did not reach its goal in this population. Better education of patients and their families about the disease and greater adherence to intensive insulin treatment can optimize the control of diabetes in pediatric patients.
INTRODUCTION: This study evaluated the demographic, clinical, and laboratory data - including traditional (as glycated hemoglobin, HbA1c) and new glycemic metrics (as time in range, TiR) - and the complications present in children and adolescents (CA) in outpatient follow-up, as well as their possible associations. METHODS: This retrospective observational study's data were compiled from the CA's medical records with T1DM (n = 78) being followed up at the Pediatric Endocrinology Service of the Federal University of Uberlândia. RESULTS: The average participants' age was 10.2 years (1-16), most of them (55%) being male, with a diagnosis time of 4.5 years (1-13), and a body mass index of 18 kg/m2. The group had HbA1c levels of 9.6% and an estimated average glycemia of 229.5 ± 103 mg/dL. TiR was 25% (7-54%); the short- (CV%) and medium-term (ΔHbA1c) glycemic variability was 45.7% and 1.5%, respectively. Approximately 10% had diabetes ketoacidosis in the last year of follow-up, about 6% had chronic complications, such as nephropathy or retinopathy, and 20% had some other associated autoimmune disease. 49% of the participants reported regular physical activity. CONCLUSION: The high values of HbA1c and glycemic variability amplitude, short TiR, and the early presence of chronic complications reveal that the treatment did not reach its goal in this population. Better education of patients and their families about the disease and greater adherence to intensive insulin treatment can optimize the control of diabetes in pediatric patients.
Authors: Anders L Carlson; Jennifer L Sherr; Dorothy I Shulman; Satish K Garg; Rodica Pop-Busui; Bruce W Bode; David R Lilenquist; Ron L Brazg; Kevin B Kaiserman; Mark S Kipnes; James R Thrasher; John H Chip Reed; Robert H Slover; Athena Philis-Tsimikas; Mark Christiansen; Benyamin Grosman; Anirban Roy; Melissa Vella; Richard A M Jonkers; Xiaoxiao Chen; John Shin; Toni L Cordero; Scott W Lee; Andrew S Rhinehart; Robert A Vigersky Journal: Diabetes Technol Ther Date: 2021-11-16 Impact factor: 6.118