Glycemic Control Rate in Patients With Type 1 Diabetes Treated at a Public Tertiary Referral Hospital in Rio de Janeiro, Brazil

Abstract

Background: The incidence of type 1 diabetes (T1D) has been increasing worldwide, leading to a serious public health problem resulting in reduced life expectancy and increased morbidity. The aim of this study was to determine the glycemic control rate and its demographic and clinical factors, in T1D followed up at a tertiary referral hospital in Brazil. Methods: An observational and retrospective study was conducted between October 2014 and October 2015. Data were obtained from 140 medical records. Results: Satisfactory glycemic control rate was found in 22.14% of patients. There was no difference between the pediatric group and adult group regarding control rate. However, a worse HbA1C level was found in the pediatric group (P = 0.001). The use of long-acting insulin analogue (P = 0.03) was associated with satisfactory glycemic control, and a tendency was observed for both the combination of long-acting and ultra-rapid acting analogues (P = 0.08), and the absence of ketoacidosis during the course of diabetes (P = 0.08). In the group with satisfactory glycemic control, the median number of consultations (1 (1 - 4)) was significantly lower than in the uncontrolled group (2 (1 - 4)) (P = 0.003). Regarding the two major microvascular complications, 23.53% had retinopathy and 12.09% had nephropathy. Conclusions: The majority of patients did not obtain a satisfactory HbA1C level. Good glycemic control factors were directly associated with the use of long-acting insulin analogues, and the combination of long-acting and ultra-rapid analogues as well as the absence of ketoacidosis during T1D’s evolution tended also to be associated with better metabolic control. J Endocrinol Metab. 2016;6(5):135-142 doi: http://dx.doi.org/10.14740/jem369w