Diabetes Mellitus tipo 1 em crianças e adolescentes em um centro de referência público no Brasil: fatores envolvidos no tratamento de diabetes e seus efeitos sobre a hemoglobina glicada

Abstract

OBJECTIVE: Evaluate the factors involved in type 1 Diabetes Mellitus treatment in children and adolescents. METODOLOGY: The cross-sectional study occurred between Sept/2020-July/2021 and involved 56 patients with previous diagnosis of type 1 diabetes, aged 0-18 years, treated at a public outpatient clinic in Sorocaba. We applied a questionnaire regarding their treatment and got HbA1c, heigh and weight values from their medical records. The analysis of associations/ differences among the data and HbA1c was made through Students t-test, ANOVA and linear regression, and we calculated standard deviation, confidence interval (95%) and significance value (p<0.05=significant). RESULTS: The study population (n=56) had a mean age of 9.67 years, 62.49% exercised less than 30min/day and 39.29% were overweight/ obese. In patients with HbA1c values registered in their records (n=49), the mean HbA1c was 81mmol/mol (9.57%). The analogous insulin regimen had a mean HbA1c=77mmol/mol (9.21%), with p-value=0.0175, while other regimens had mean HbA1c>86mmol/mol (10%). The follow-up to a food plan reduced the HbA1c from 107mmol/mol (11.9%) to 67mmol/mol (8.33%), with p-value=0.0027. Patients aged 2-10 years had HbA1c=69mmol/mol (8.45%), compared to 98mmol/mol (11.19%) in those aged 11-18 years (p-value=0.0004). CONCLUSION: The findings highlight the poor glycemic control in children/adolescents with type 1 diabetes and a high prevalence of sedentarism and overweight/obesity. There was an inverse association between the HbA1c and the use of analogous insulins, follow-up to a food plan and age 2-10 years. These factors should be considered during the treatment plan for type 1 diabetes.