The impact of management program for children with diabetes in China on the glycemic control of type 1 diabetic mellitus children and factors associated with glycemic control / 中华实用儿科临床杂志

ABSTRACT

Objective To compare the glycemic control of different management approaches in type 1 diabetic mellitus (T1 DM) children,and to evaluate the influence factors associated with glycemic control.Methods This survey included 68 T1DM children from January 2012 to December 2014 in the Affiliated Hospital of Qingdao University of more than 1 year management.Hemoglobin A1c (HbA1c) levels were detected to assess glycemic control.Twenty-three T1DM children who participated in the World Diabetes Foundation(WDF) management program (group A) were compared with 45 T1DM children who were managed by themselves (group B).The clinical data were analyzed to explore the correlations with glycemic control.Results The HbA1c of 68 children was (8.86 ± 2.00)％,and only 21 cases (30.9％) had optimal HbAlc (HbAlc ＜ 7.5％).The level of HbA1 c of group A (7.60 ± 1.57)％ was significantly lower than that of group B[(9.40 ± 1.91) ％] (t =-4.045,P =0.001).Group A had less fluctuation in blood glucose than group B,which the duration more than 3 years.Duration (F =2.277,P =0.004),frequency of self-monitoring blood glucose (F =9.375,P =0.001),diabetic education (F =3.276,P =0.002),and diabetic diet (t =-2.046,P =0.025) were associated with glycemic control.Conclusions The glycemic control of T1 DM children at the Affiliated Hospital of Qingdao University was at the medium level,most of them haven't reached the target levels.The WDF management program could significantly and continuously monitor the glycemic level.Diabetic education and more frequent self-monitoring blood glucose and diabetic diet are associated with better glycemic control.