Chronic Complications of Type 1 Diabetes in Children

Abstract

Introduction: Chronic complications of type 1 diabetes are rare in children The aim of this work is to determine their prevalence in paediatric settings and the factors associated with them Methodology: This was a prospective study, conducted in two reference services in the management of childhood diabetes at the University Hospital of Dakar. We included all patients with type 1 diabetes under 20 years of age as recommended by the 2009 ISPAD. Results: Of the 67 patients in our cohort, only 46 met the inclusion criteria. There were 19 boys and 27 girls. The average age was 11.57 years +/- 4.3 years. The average age of discovery was 8.71+/- 3.8 years. The average duration of the evolution was 34 months. Almost half of the patients had an average glycated hemoglobin greater than 9%. Growth retardation was severe in 17% and moderate in 11% of cases. Five patients (20%) had significant microalbuminuria and 5 (20%) had retinopathy, 3 with macular edema and 2 with diffuse microhaemorrhages. Multivariate analysis of the different parameters studied showed that retinopathy was associated with high HbA1c values (p=0.043) and poor compliance (p=0.021). Kidney disease was only associated with poor adherence with p=0.0025. Conclusion: Chronic complications of T1D are not that uncommon, especially in our regions where management is not optimal. We suggest that they be detected around 10-11 years of age regardless of how long the diabetes progresses.