Indian pediatrics · 2019
Glycemic Control and Long-term Complications in Pediatric Onset Type 1 Diabetes Mellitus: A Single-center Experience from Northern India.
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Sudhanshu Siddhnath, Nair Veena V, Godbole Tushar, Reddy S Vijay Bhaskar, Bhatia Eesh, Dabadghao Preeti, Sharma Kumudini, Arora Pratibha, Bano Sayda, Singh Anulina, Bhatia Vijayalakshmi
Аннотация
OBJECTIVE: To study glycemic control, mortality and long-term complications in children with type 1 diabetes (T1D).
DESIGN: Cross-sectional study.
SETTING: Referral centre at a government teaching hospital.
PARTICIPANTS: Patients with T1D with age £18 years at onset.
METHODS: We retrospectively collected demographic data from computer records from 1991 to 2015. Prospective study for outcomes was conducted between 2012 and 2016.
MAIN OUTCOME MEASURES: Mortality rate, glycosylated hemoglobin (HbA1c), and microvascular complication rate.
RESULTS: The proportion of T1D patients (n=512) <5 years of age at onset was 18.6% between 1995 and 2004, and 24.2% in 2005-2014 (P<0.001). Twenty eight patients had died out of 334 whose living status was known (mortality 1.1 per 100 patient-years over 2549 patient-years follow up). Median (range) HbA1c (n=257) was 8.3% (5.1-15.0%). At least one episode of severe hypoglycemia (coma/seizure/inability to assist self) had occurred in 22.8% patients over two years. Hypertension was present in 11.7% patients. Microvascular complications screen in 164 eligible patients [median (range) age 20 (8-45) y and duration of diabetes 9.1 (5-30) y] showed diabetic nephropathy in 3.0%, proliferative retinopathy in 3.6% and LDL cholesterol >100 mg/dL in 34% patients.
CONCLUSIONS: The mortality rate and prevalence of hypertension were high, given the short duration of diabetes of the patients. The proportion of patients with age ≤5 years at onset of diabetes has increased at our center.
DESIGN: Cross-sectional study.
SETTING: Referral centre at a government teaching hospital.
PARTICIPANTS: Patients with T1D with age £18 years at onset.
METHODS: We retrospectively collected demographic data from computer records from 1991 to 2015. Prospective study for outcomes was conducted between 2012 and 2016.
MAIN OUTCOME MEASURES: Mortality rate, glycosylated hemoglobin (HbA1c), and microvascular complication rate.
RESULTS: The proportion of T1D patients (n=512) <5 years of age at onset was 18.6% between 1995 and 2004, and 24.2% in 2005-2014 (P<0.001). Twenty eight patients had died out of 334 whose living status was known (mortality 1.1 per 100 patient-years over 2549 patient-years follow up). Median (range) HbA1c (n=257) was 8.3% (5.1-15.0%). At least one episode of severe hypoglycemia (coma/seizure/inability to assist self) had occurred in 22.8% patients over two years. Hypertension was present in 11.7% patients. Microvascular complications screen in 164 eligible patients [median (range) age 20 (8-45) y and duration of diabetes 9.1 (5-30) y] showed diabetic nephropathy in 3.0%, proliferative retinopathy in 3.6% and LDL cholesterol >100 mg/dL in 34% patients.
CONCLUSIONS: The mortality rate and prevalence of hypertension were high, given the short duration of diabetes of the patients. The proportion of patients with age ≤5 years at onset of diabetes has increased at our center.