Determinants of outcome of children with type 1 diabetes in the North West Region of Cameroon

Niba, Loveline Lum (2016): Determinants of outcome of children with type 1 diabetes in the North West Region of Cameroon. Dissertation, LMU München: Faculty of Medicine

Abstract

Background: In sub-Saharan Africa the prognosis of children with type 1 diabetes is poor. Many are not diagnosed and those that are diagnosed have a reduced life expectancy (less than one year). This study set out to identify the factors that predict glucose control in children and adolescents with type 1 diabetes in the North West Region of Cameroon. Methods: A hospital based cross-sectional study involving 76 children/adolescents (41 girls and 35 boys, mean age of 15.1 ± 3.1 years) suffering from type 1 diabetes included in the “Changing Diabetes in Children” (CDiC) program and attending the clinics for children living with type 1 diabetes in the North West Region. Data on glycosylated haemoglobin (HbA1c) as well as clinical and biochemical parameters at diagnosis and during the study period were obtained from the hospital records of participants. A structured questionnaire was used to obtain information on socio-demographic characteristics and diabetes related practices from participants. Odds ratios (OR) were calculated using logistic regression to assess the association between determinants and good glucose control. Results: The study population had a mean HbA1c of 10.3 ± 2.9%. There was a significant decrease in the mean HbA1c from diagnosis (11.1%) to the study period (10.3%) (p = 0.011). Multivariate analysis indicated that having a mother as the primary caregiver (OR 0.02, 95% CI 0.002 – 0.189) and minimal/moderate caregiver involvement in insulin injection (OR 26.8, 95% CI 4.4 – 56.1) were independent predictors of glucose control. Conclusion: This study has demonstrated that having a mother as a primary caregiver is an important predictor of good glycaemic control among children with type 1 diabetes. It is currently unclear whether the direct involvement of the mother is important or whether “mother as a primary caregiver” is a strong indicator for a setting in which diabetes treatment is possible.

• Item Type: Theses (Dissertation, LMU Munich)
• Keywords: Predictors, glucose control, HbA1c, type 1 diabetes, children/adolescents.
• Subjects: 600 Technology, Medicine; 600 Technology, Medicine > 610 Medical sciences and medicine
• Faculties: Faculty of Medicine
• Language: English
• Date of oral examination: 21. November 2016
• 1. Referee: Parhofer, Klaus
• Signature of the printed copy: 0700/UMD 17130