P-103: Type 1 diabetes chronic complication prevalence and association with continuous glucose monitoring measurements in Ugandan children and youth
T Piloya Were, K Meeks AC, C Agyemang, C Nyangabyaki, S Bahendeka, D Malinga, J Nambooze, E Papenffus, A MoranAbstract
Introduction
Survival of children and youth with type 1 diabetes (T1D) in Uganda has improved, but glycemic control remains suboptimal and chronic complications screening is limited. HbA1c is the main monitoring tool, as continuous glucose monitoring (CGM) is rarely available.
Objectives
To determine the prevalence of diabetes-related chronic complications and assess associations with clinical factors, HbA1c and CGM measures among youth with TID in Kampala
Methods
Cross-sectional study of 205 participants ages 4–26 years at two clinics. Data included sociodemographic, clinical history, HbA1c, and 14-day CGM. Screening included retinopathy (fundoscopy), microalbuminuria (ACR ≥3 mg/mmol), hyperlipidemia (LDL ≥2.6 mmol/L), neuropathy, and hypertension. Multivariable logistic regression assessed associations.
Results
Mean age 16.8 (SD 5.4) years, diabetes duration 6.0 (SD 4.3) years. Glycemic control was poor; mean HbA1c 10.3% (SD 2.4); only 9% had HBA1C<7%. Mean glucose; 13.3 (SD 4.3) mmol/l, mean percent Time in range (TIR); 33.8 (SD 20.9), mean time below range; 8.5 (SD 7.7); mean time above range; 61.7 (SD 22.3), Mean CV; 43.4 (SD 10.4).
Prevalence of complications included: hyperlipidemia (50%); microalbuminuria (21%); hypertension (18%); peripheral neuropathy (17%), and retinopathy (6%). Higher TIR was associated with lower odds for microalbuminuria (0.95, CI=0.93-0.98). Diabetes duration (OR 1.21, CI 1.10-1.33) and hypertension (OR-5.13, CI 2.13- 12.36) were associated with increased odds of microalbuminuria. Retinopathy was associated with longer duration (OR=1.25, CI=1.08-1.44), hypertension (OR 5.02 (CI 1.31 -19.19), and history of severe hypoglycemia (OR=0.11, CI=0.02-0.73).
Conclusions
Chronic complications are highly prevalent among Ugandan children and youth with T1D and with poor glycemic control. Improving TIR and managing blood pressure are critical to reduce long-term morbidity as survival and diabetes duration increase