Glycemic control and treatments in type 1 diabetes in childhood and adolescence in Portugal

Abstract

The Pediatric Portuguese Society of Endocrinology and Diabetology established in 2001 a Study Group with the aim of investigate glycemic control, prevalence of microvascular complications and modalities of treatments in type1 diabetic patients. The cases for registration were those who were born between June 1, 1979 and June 1, 2001 (until 22 yr of age). A front sheet was constructed to record, age at diabetes diagnosis, diabetes duration, presence or absence of diabetes microvascular complications, HbA1c, number of capillary glycemic tests per week and type of insulin treatment. Twenty-two Hospitals participated and a total of 1009 patients were registered. The mean age was 13.6 yr+/-4.7, mean age at diabetes diagnosis 8.4 yr+/-4.4, and diabetes duration 5.2 yr+/-3.95. Diagnosis of diabetes was done in 22.8% by the age group 0-4 yr, in 36.4% by the age group 5-9 yr, in 32.4% by the age group 10-14, in 6.7% by the age group 15-19, and in 1.5% by the age group 20-22. Retinopathy was present in 1.4% and nephropathy in 6.4%. Values of HbA1c <7.5% were achieved in 12.5%, > or =7.5 and < 8% in 11.3%, > or =8 and <9.5 in 33.5% and > or =9.5 in 40.9%. Insulin treatment with one daily injection was used in 1.5%, with two daily injections in 35.4%, with three daily injections in 35% and with four or more in 26.4%. This study showed that this large cohort of type1 diabetic patients had a bad metabolic control and the goal of near normoglycemia was achieved in only a few patients.