Chronic Complications of Type 1 Diabetes in Children

Abstract

Djibril Boiro, Babacar Niang, Jean Pierre Diagne, El hadji Malick Sy, Amadou Sow, Oumou Fadly Toure, Maimouna Toure, Aminata Mbaye, Aliou Abdoulaye Ndongo, Aliou Thiongane, Demba Diedhiou, Ndiogou Seck, Modou Gueye, Ousmane Ndiaye and Papa Amadou Ndiaye

Introduction: Chronic complications of type 1 diabetes are rare in children The aim of this work is to determine their prevalence in paediatric settings and the factors associated with them

Methodology: This was a prospective study, conducted in two reference services in the management of childhood diabetes at the University Hospital of Dakar. We included all patients with type 1 diabetes under 20 years of age as recommended by the 2009 ISPAD. \

Results: Of the 67 patients in our cohort, only 46 met the inclusion criteria. There were 19 boys and 27 girls. The average age was 11.57 years +/- 4.3 years. The average age of discovery was 8.71+/- 3.8 years. The average duration of the evolution was 34 months. Almost half of the patients had an average glycated hemoglobin greater than 9%. Growth retardation was severe in 17% and moderate in 11% of cases. Five patients (20%) had significant microalbuminuria and 5 (20%) had retinopathy, 3 with macular edema and 2 with diffuse microhaemorrhages. Multivariate analysis of the different parameters studied showed that retinopathy was associated with high HbA1c values (p=0.043) and poor compliance (p=0.021). Kidney disease was only associated with poor adherence with p=0.0025.

Conclusion: Chronic complications of T1D are not that uncommon, especially in our regions where management is not optimal. We suggest that they be detected around 10-11 years of age regardless of how long the diabetes progresses.

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