| Autor: |
Савова, Р., Аршинкова, М., Кондуржиев, Т., Ганчева, В., Модева, И., Янева, Н., Славчева-Проданова, О., Владимиров, Т., Константинова, М. |
| Zdroj: |
Pediatria; 2020, Vol. 60 Issue 2, p25-30, 6p |
| Abstrakt: |
Introduction. Glycemic control of diabetes mellitus depends on patient’s and family education, motivation and quality of medical care. Objectives. To access overall tendency of changes of metabolic control among hospitalized children since 1991 and to analyze the structure of hospitalizations in 2010 and 2017/2018 according to reasons for hospital admission. Material and methods. Glycated hemoglobin (HbA1c) was assessed in random sample of hospitalized children with previously previously established Type 1 diabetes at the time interval 1991-1998 and in all hospitalized children in 2010 and April 2017-March 2018 . The level of glycemic control was analyzed in relation to the maternal education (elementary, secondary or university) and to the reasons for admission (6 clinical groups): 1. Severe hypoglycemia 2. Severe ketoacidosis, pH<7.20 3. Gastrointestinal diseases/vomiting 4. Other infections, traumas, perioperative stress 5. Worsened/permanently poor control 6. Treatment assessment/change of insulin regimen and preparations Results. A total of 1366 HbA1c measurements from 251 children were included at the time interval 1991-1998, 184 hospitalizations (160 children) in 2010 and 172 hospitalizations (151 children) in 2017. ANOVA and ANCOVA analysis established significant overall reduction of HbA1c from 1991 to 2018, controlled for age and disease duration at the time of investigation. HbA1c is inversely related to the maternal level of education: 10.56% ± 2.57%, 8.9%±2.1% and 7.79% ±1.53% (p<0.05) respectively for elementary, secondary or university (2017). The proportion of low educated parents in 2017 compared to 2010 has increased from 16.36% to 27.4%. Children hospitalized for severe hypoglycemia were reduced from 21 (2010) to 2 (2017). Cases with severe ketoacidosis were 15 in 2010 and 12 in 2017, all but 1 of of them with poor control: (НвА1с 11.4±1.64% (2010) and 10.02+1.68% (2017) and pubertal age. НвА1с in the subgroups 3-6, hospitalized for infections and treatment readjustment varied from 8 to10%. Conclusions. There is a positive trend for general improvement in HbA1c with concomitant significant reduction of the cases with severe hypoglycemia. Severe ketoacidosis is still a problem for children with poor control and pubertal age. Level of maternal education is inversely related to the level of metabolic control. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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