factors which affect the glycemic control

8/10/2019 Factors Which Affect the Glycemic Control

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FACTORS WHICH AFFECT THE

GLYCEMIC CONTROL INCHILDREN WITH TYPE 1 DIABETES

Author: Claudiu TEODORESCUCo-authors: Oana-M dlina TURTUREA,

Marinela-Georgiana TATU,

Iulia-Anca MARIAN,Mdlina -Victoria TIA

Coordinators: Assoc. Prof. Ileana PUIU MD, PhD ;

G. TARTEA, MD


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INTRODUCTION

Type 1 diabetes is among the most commonendocrine and metabolic disorder at children andadolescents, with a rising incidence worldwide and

in our country.

Diabetes is a chronic disease of children, evolving inthe form of equilibration period, therapeutically

achieved (diet and insulin), alternating with periodsof metabolic imbalance, infection-related, foodexcess, lack of suitable therapy.


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PATIENTS AND METHODS

The study included 41 patients with type 1 diabetesdiagnosed, registered and monitored in I PediatricClinic, Clinical Emergency County Hospital Craiova.

The study was based on a questionnaire that wascompleted by the parents of children and adolescentswith type 1 diabetes after was obtained the parentalaccordance with the regulations of the EthicsCommittee of the Emergency County Hospital Craiova.

The aim of the study was to identify factors thatinfluence glycemic control in children with type 1diabetes.


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PATIENTS AND METHODS

The questionnairecompleted by parents


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RESULTS The age of patients at the time of the study, was between 4

and 18 years. Children were assigned to three age groups

Analysing the relationship between HbA1c and age groups, was found

that the age group between 7-12 years had most patients (72%) withglycemic imbalance

0% 20% 40% 60% 80% 100%

0 - 6 ani

7 - 12 ani

13 - 18 ani

33%

28%

45%

67%

72%

55%

The relationship between HbA1c andage groups

HbA1c7.50%

7%0 - 6 yo

34%7 - 12 yo

59%13 - 18 yo

The incidence by age groups


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RESULTS The highest incidence of cases depending on the average age of

onset for F sex was 10 years (31.2%); for M sex was 14 years old(12%), which correlated with puberty.

6.2% 6.3%6.3%

12.5%

6.2%6.2%

31.2%

12.5%

6.2% 6.2%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

2ani

3ani

4ani

5ani

6ani

7ani

8ani

9ani

10ani

11ani

12ani

13ani

14ani

15ani

16ani

The incidence based on age ofonset and gender F

F

4%

8% 8%

4%

8% 8% 8%

4%

8% 8%

12%

4%

0%

2%

4%

6%

8%

10%

12%

14%

2

ani

3

ani

4

ani

5

ani

6

ani

7

ani

8

ani

9

ani

10

ani

11

ani

12

ani

13

ani

14

ani

15

ani

16

ani

The incidence based on age ofonset and gender M

M


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RESULTS

Analysing the relationshipbetween HbA1c and source

environment , it has been foundthat glycemic imbalance

(68.43%) predominated in ruralchildren.

54,65%Urban

46,35%Rural

The incidence of T1D in area of

origin

Urban

Rural

0% 20% 40% 60% 80% 100%

URBAN

RURAL

45.45%

31.57%

54.55%

68.43%

Relations between HbA1c andenvironment

HbA1c7.50%


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RESULTS

Analyzing the relationship betweenHbA1c and duration of diabetes have

found that glycemic imbalance occursin the first year of evolution (60%), andbetween 2-5 of evolution tends todecrease, followed to grow againbetween 6 - 12 years of evolution(70%).

24.00%


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RESULTS

In terms of education level

of parents, the highest glycemic

imbalance was met parents who

had only gymnasium studies(76%), followed by those with

University (66%).

43.90% StudiiGimnaziale

26.82%

Studii Liceale

29.26% StudiiUniversitare

Nivelul de educaie al prinilor

0% 20% 40% 60% 80% 100%

Studii Gimnaziale

Studii Liceale

Studii Universitare

23.52%

72.72%

33.34%

76.48%

27.28%

66.66%

The relationship between HbA1c andeducation level of parents

HbA1c7.50%


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RESULTS

31.70% Mama

43.90% AmbiiPrini

24.40% Prinisi copilul

Membrii familiei cei mai implicai n

ngrijirea Diabetului

0% 20% 40% 60% 80% 100%

Ambii Parinti

Mama

Parinti si copilul

33.34%

38.46%

40%

66.66%

61.54%

60%

The relationship between HbA1c andmembers most involved in the care of

Diabetes

HbA1c7.50%

The relationship betweenHbA1c and most involved

family members in diabetescare was found that thehighest glycemic imbalanceoccurs when only the parentsare involved(66%), not the

child.


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RESULTS

Analyzing the correlationbetween HbA1c and method ofcalculation of carbohydrate inthe diet, was found thatglycemic imbalance was more

frequent (80%) in children whonot weighed their food.

63.41%Cntrire

36.58%Experient

Setting the diet

0% 20% 40% 60% 80% 100%

Cantarire

Experienta

46.15%

20%

53.85%

80%

The relationship between HbA1c andhow to calculate carbohydrate

HbA1c7.50%


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results

The relationship between HbA1c and physical activity showed that children

who were doing physical activitysporadically, showed glycemicimbalance in 92%.

34.14%

Sporadic

65.86%Constant

Activitatea fizic

0% 20% 40% 60% 80% 100%

Sporadic

Constant

7.14%

51.85%

92.86%

48.15%

The relationship between HbA1c andphysical activity

HbA1c7.51%


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RESULTS

Analysing the relationshipbetween HbA1c and

family conflicts , it was found that patients whoalways family conflicts theglycemic imbalance is100%.

9% Nu

39%Foarte rar

30% Uneori

22% Mereu

Conflicte familiale legate de DZ

0% 20% 40% 60% 80% 100%

Nu

Foarte rar

Uneori

Mereu

75%

56%

30%

25%

44%

70%

100%

The relationship between HbA1c andfamily conflicts

HbA1c7.50%


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CONCLUSIONS Analyzing the factors that influence glycemic control at childrenwith type 1 diabetes, we found: The age group between 7 - 12 years most patients (72%) had aglycemic imbalance; For children from rural areas there was a higher prevalence ofglycemic imbalance (68.43%) compared to urban areas; Children who have family conflicts always have glycemicimbalance(100%); Children who were doing physical activity sporadically, showedglycemic imbalance in 92%. The children who not weighed the food to establish thecarbohydrate in the diet, showed glycemic imbalance in 80%; The children whose parents had only gymnasium studies had the

highest glycemic imbalance (76% of cases); The children in Tanner pubertal stage 5 had glycemic imbalancemost frequently (73% of cases); Glycemic imbalance occurs more frequently in the first year of

development (60% of cases); Glycemic imbalance occurs more frequently (66%), when are

involved in only parents and not the children, in the diet.


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Thank you!

factors which affect the glycemic control

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