Outcomes of Health Care Services Provided to Egyptian Patients with Type 1 Diabetes Mellitus: A Single Centre Experience from a Developing Country

Abstract

Abstract Background Despite the existence of evidence-based guidelines for the care of children with diabetes, widespread gaps in knowledge, attitude, and practice remain. Aim of the work: To evaluate the current health care services provided to patients with type 1 diabetes registered in Pediatric and Adolescent Diabetology Unit (PADU), Children's hospital of Ain-Shams University, in terms of metabolic control and complications encountered. Methods This retrospective cross-sectional study was conducted on 672 patients attending PADU. Patients' data was extracted from their records including baseline and follow up examination and investigations. Results Mean age of studied patients is 12.63 ± 3.41 years, mean BMI is 20.11 ± 4.03 (kg/m2) with a median diabetes duration of 5.54 ± 3.07 years. Mean HbA1c of all patients was 8.75 ± 1.94%, with 86.9% of patients having HbA1c > 7%. The mean number of blood glucose monitoring is 2.43 ± 0.64 times/day and mean insulin dose is 1.17 ± 0.27 u/kg/day. Regarding microvascular complications 6.7% had nephropathy ,4.9% had peripheral neuropathy, no retinopathy and 10.85% had hyperlipidemia. Patients with more than 5-year-diabetes duration have significantly higher cholesterol level (167.58 ± 38.02 versus 163.23 ± 35.54 mg/dl), higher LDL (100.23 ± 29.49 versus 95.70 ± 28.11 mg/dl), and lower number of SMBG (2.24 ± 0.66 versus 2.58 ± 0.57 times/day, p < 0.05 for all). Conclusion These results are a testimony of the reality managing diabetes by dynamic teams striving to achieve recommended standards of care for pediatric diabetes in an environment with limited resources.