The status of type 1 diabetes in children in the Eastern region of the UAE

Abstract

Introduction: Type 1 diabetes mellitus (T1DM), the most common type of diabetes in children, is known to be globally undercontrolled. Factors related to insulin regimen, mode of treatment or glucose monitoring (GM) have been linked to affecting diabetes control. No one has looked at this data in the UAE Eastern Region. Aim: (i) Identify the demographics of children and adolescents with T1DM. (ii) Assess the level of diabetes control. (iii) Investigate the presence of comorbidities or complications and (iv) Explore the correlation between diabetes control and potential clinical or demographic factors. Method: We conducted a retrospective cohort study for T1DM patients, ≤18 years, between January 2009 and June 2020 at a main tertiary hospital in the UAE Eastern Region. We calculated the average glycosylated haemoglobin (HbA1c) for the 1st, 2nd and 3rd year (final) separately. The association of pre-selected variables with the average HbA1c of the final year of follow up was assessed by univariate analysis using independent samples t-test and ANOVA. Results: Out of 243 patients, 62.6% were UAE Nationals and 54.3% were female. The mean age, age at presentation and T1DM duration were 12.04 (3.91) years, 6.64 (3.88) years and 5.15 (3.69) years, respectively. The average (HbA1c) was 8.64% (1.58). Positive autoantibodies were reported in 76.4% of patients, 18.1% had a positive family history of T1DM and 38.8% presented with diabetic ketoacidosis. GM was done by intermittently-scanned continuous GM (isCGM), self-monitoring blood glucose (SMBG) and continuous GM (CGM) in 48%, 33% and 19% of the patients, respectively. Sixty-five percentage of patients were on multiple daily injections regimen and 44% had comorbidities or complications. HbA1c was higher in older patients, patients with positive family history of T1DM, and patients with less GM frequency. There was no difference in HbA1c regarding gender, nationality, treatment regimen or method of GM. Conclusion: T1DM in children and adolescents is undercontrolled in the Eastern Region of UAE. Factors associated with worse control are age, positive family history of T1DM, baseline HbA1c and less GM frequency, while gender, nationality, treatment regimen or method of GM had no correlation.