P-289: Predictors of retention and early clinical outcomes in children and adolescents with type 1 diabetes in the CDiC program in Bangladesh
M M Rahman, M A Habib, K Huda, B Ahmed, B ZabeenAbstract
Introduction
Retention in structured diabetes care programs is essential for improving glycaemic control and preventing complications in children and adolescents with type 1 diabetes (T1D), especially in low- and middle-income countries.
Objectives
To assess retention at 6–12 months and evaluate early clinical outcomes and predictors of retention among children and adolescents with T1D enrolled in the CDiC program in Bangladesh.
Methods
This longitudinal cohort study included 415 children and adolescents with T1D enrolled within 6 months of diagnosis from regional CDiC centres across Bangladesh (March 2024–March 2026). Clinical outcomes at <6 months and 6–12 months were analysed using paired t-tests, and multivariable logistic regression was used to identify predictors of retention.
Results
Retention at 6–12 months was 66.7%. Fasting blood sugar (FBS) decreased from 15.11 ± 7.79 to 8.12 ± 6.31 mmol/L (n = 133, p < 0.001). Total daily insulin dose (TDD) increased from 37.48 ± 22.22 to 45.82 ± 28.29 units (n = 366, p < 0.001). HbA1c improved from 11.06 ± 3.04% to 9.97 ± 1.99% (p < 0.001). The proportion of diabetic ketoacidosis (DKA) decreased from 8.4% to 1.2% (n = 415). Older age at diagnosis (OR 1.265, p < 0.001) and higher socioeconomic status (OR 2.523, p < 0.001) were associated with higher retention, whereas lower education status (OR 0.711, p = 0.027), higher TDD (OR 0.969, p < 0.001), and lower patient satisfaction (OR 0.432, p = 0.004) were associated with lower retention.
Conclusions
Retention in the program was moderate and associated with improved glycaemic control and fewer DKA episodes. At the same time, socio-economic status and age at diagnosis were key determinants of retention in this resource-limited setting.