Original Article

Impact of Socioeconomic Characteristics on Metabolic Control in Children with Type One Diabetes in a Developing Country

10.4274/jcrpe.galenos.2019.2019.0014

  • Abeer Alassaf
  • Rasha Odeh
  • Lubna Gharaibeh
  • Sarah Ibrahim
  • Kamel Ajlouni

Received Date: 01.02.2019 Accepted Date: 14.04.2019 J Clin Res Pediatr Endocrinol 0;0(0):0-0 [e-Pub] PMID: 30991788

Background:

Adequate glycemic control in children with type 1 diabetes reduces the risk of future complications. Identifying factors affecting HbA1c is crucial to achieve adequate metabolic control. We aim to identify possible socioeconomic predictors of poor metabolic control in children with type 1 diabetes in Jordan; which resembles a developing country with limited resources.

Methods:

Medical charts were reviewed for patients attending the pediatric endocrine clinics in two major diabetes centers. HbA1c ≥ 7.5% (58 mmol/mol) was considered as poor metabolic control. Logistic regression analysis was performed to identify predictors of poor glycemic control. Visual association between the socioeconomic characteristics and metabolic control was evaluated using multiple correspondence analysis (MCA).

Results:

Two hundred and fifty-nine children were enrolled in the study, one fifth of patients (20.5%) achieved HbA1c < 7.5%. Dietary non-compliance (OR: 3.533, CI: 1.803- 6.926, p < 0.001), and being overweight (OR: 3.869, CI: 1.218- 12.294, p = 0.022) were more likely to have poor metabolic control. Children whose mothers have bachelor’s degree or higher were less likely to have poor metabolic control compared to children whose mothers had only elementary education (OR: 0.241, CI: 0.079 - 0.734, p = 0.012). Multiple correspondence analysis revealed an association between low socioeconomic status and poor metabolic control. Children with deceased mothers had significantly higher HbA1c levels than any other subgroup.

Conclusion:

Certain socioeconomic characteristics were associated with poor metabolic control. Identifying children with these risk factors might play an important role in optimizing metabolic control and provide better diabetes care.

Keywords: Type 1 diabetes, HbA1c, Metabolic control, Socioeconomic status, Jordan