Evaluation of the Current International Registry Update for Children and Adolescents with Diabetes Mellitus Following Up in Diabetes Clinic, Pediatric Hospital, Ain Shams University

Abstract

Background Diabetes team should have the access for receiving continuous feedback for the health care service to help successful improvement. Health professionals need to continuously work to improve the quality of pediatric diabetes care to reduce the risk of acute and chronic complications. Objective: To evaluate the current international SWEET registry update for the children and adolescents following regularly at Pediatric and Adolescents Diabetes Unit (PADU) during a period of six months and updating the existing electronic medical record (Database) in (PADU) to provide measures to improve patients outcome regarding both acute and chronic complications. Patients and Methods The present study is a prospective follow up study performed on 385 patients with diabetes mellitus type1, with a mean age 11.79 ± 4.16 years. All patient with diabetes mellitus type1 visiting diabetes clinic (PADU) were included in the study after obtaining an informed consent. Results Patients with longer diabetes duration have significant higher insulin dose, more attacks of DKA and less attacks of hypoglycemia comparing to those with shorter duration. Patients with poor glycemic control have more attacks of DKA (62 patients vs 58 patients), (p-value=0.046), and less attacks of hypoglycemia (25 patients vs 65 patients), compared to properly controlled patients (p-value=0.000). Patients on insulin pump show significant improvement of them HbA1c (11% vs 7.3%) (p –value=0.000), cholesterol (173 mg/dl vs 139.8 mg/dl) (p- value= 0.006) and SMBG (2.7 times vs 4.6 times) (p-value= 0.000), compared to patients on multiple daily injections (MDIs). Conclusion Diabetes care is the cornerstone for proper glycemic control and prevention of long term complications. This study showed the value of a registry system to enable monitoring of patients over many years. The study could be an important step in the development of a national registry system for diabetes in Egypt.