P-466: Glycemic control and acute diabetes complications in children and adolescent patients with type 1 diabetes mellitus attended at outpatient clinic in a tertiary centre in Botswana
D Joel, Z Yeni, G RwegereraAbstract
Introduction
Type 1 Diabetes Mellitus (T1D) results from autoimmune destruction of the β-cells of the pancreas, which results in deficiency of insulin. There is limited information characterizing glycemic control and acute diabetes complications in T1D in children and adolescents in Botswana.
Objectives
To determine the glycemic control status and the prevalence of acute complications of TID among children and adolescents seen at the Pediatrics Endocrinology clinic in a Tertiary Centre in Botswana.
Methods
A cross-sectional study was conducted among children and adolescents from 28th October 2021 to 13th April 2022 at the Pediatric Endocrinology Clinic in Princess Marina Hospital, Botswana. Social demographic characteristics/clinical information was collected using a semi-structured questionnaire. Glycosylated (HbA1c) was used to determine the glycemic control and a cut-off of < 7.0% for good glycemic control as per ISPAD guidelines. Bivariate analysis was used to assess predictors of poor glycemic control and acute complications. A p-value of < 0.05 was considered statistically significant.
Results
One hundred and thirty one (131) participants were included in the final analysis. The mean HbA1c was 10.4% in more than two thirds of the participants. Overweight/obesity were associated with good glycemic control as compared to underweight [33.3% versus 9.3%] (p-value=0.045). Participants with employed caregivers/parents were at increased risk of poor control (p-value=0.049). Six months prior to enrollment, majority of participants developed hypoglycemia. Being overweight/obese was twice associated with developing DKA compared to underweight [COR=1.72; CI=2.57, 9.29; p-value= 0.045]. Poor glycemic control was significantly associated with occurrence of DKA [COR=0.99; CI=1.36, 5.13; p-value= 0.038].
Conclusions
The mean HbA1c was 10.4%, indicating poor T1D glycemic control in children and adolescents in Botswana. Further glycemic control improvement is warranted.