Factors affecting glycemic control in patients attending peadiatric diabetic clinic at QECH
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Date
2022-02-09
Journal Title
Journal ISSN
Volume Title
Publisher
Kamuzu University of Health Sciences
Abstract
1.0 Executive summary
This is a quantitative cross-sectional study aimed at analyzing factors affecting glycemic control
in patients attending pediatric diabetic clinic at Queen Elizabeth Central Hospital. The study will
analyze factors affecting glycemic control and determine the proportion of patients with poor
glycemic control. Patients will also be assessed for possible complications. Participants will be
selected using convenient sampling method. Data will be collected using questionnaires and
managed using Microsoft excel. Results will be presented at research dissemination at the end of
research block at College of Medicine. The results will help improve management of diabetes
patients and to prevent complications and other comorbidities.
2.0 Background
Diabetes is a chronic non communicable disease which occurs when the pancreas produces
insufficient insulin or when the body cannot effectively use the available insulin. Type 1 diabetes
mellitus is an autoimmune disease which results from cellular mediated destruction of beta cells
of the pancreas characterized by deficient insulin production. Type 1 diabetes mellitus (T1DM) is
one of the most common chronic conditions in children, and it represents a global public health
challenge
There is an association between poor glycemic control and study level of patients, healthy eating
habits and diabetes duration. Patients who have had diabetes for a longer duration betteglycemic control as compared to new onset diabetics(1).Additionally, there is poor glycemic
control in African children especially adolescents. About 4% of children above 12 years of age
have reasonable control compared to 78% of children less than 12 years(2). Body mass index,
guardian education level and insulin type are some also factors associated with poor glycemic
control(3).
Furthermore, metabolic control is poor in type 1 diabetics population with overall poor
adherence. Other factors associated with poor control were include older age, a caregiver other
than the mother and poor adherence to Blood glucose monitoring(4).
However, some studies have been done to find out ways of ensuring good glycemic control.
Diabetic youth education camps have a positive impact on glycemic control(5).Additionally,
diabetic education significantly reduces the risk of severe hypoglycemia, though better glycemic
control cannot always be achieved(6).
Poor glycemic control is associated with many acute complications. There is a high proportion
of severe hypoglycemia and Diabetic Ketoacidosis (DKA) among patients attending diabetic
clinic. There is also significant relationship between Diabetic Ketoacidosis (DKA) and mode of
storage of insulin, most of the participants use the traditional storage method that is a clay pot
with sand and water kept at the coolest place in their home. 97.56% of the participants had poor
control of Type 1 diabetes mellitus with a mean HbA1c 0f 13.22%(7).
Furthermore, inadequate knowledge on; diabetes complications; management of hyperglycemia;
appropriate self-monitoring of blood glucose; differences in signs and symptoms of
hyperglycemia and hypoglycemia and provision of psychological support contributes to poor
glycemic control(8).