Muhimbili NH: Survey on acute & chronic complications in children + adolescents with Diabetes 1

If you can't read a long post, please scroll down to the near bottom of this post and read the "RESULTS" or "CONCLUSION" part to get a take home message.

I congratulate everybody that participated in this research study even more, appreciate the effort made to circulate the results for us to read. To some extent we acknowledge the presence of this, yet, another major illness namely Malaria, TB and HIV/AIDS wallowing around. This is a challenge to individual and the whole health care system to do more in promoting our health and prevent and/or cure complications arising from Diabetes.

This is a summary report on the "Survey on acute and chronic complications in children and adolescents with type 1 diabetes at Muhimbili National Hospital in Dar es Salaam, Tanzania"

Authors: Majaliwa ES, Munubhi E, Ramaiya K, Mpembeni R, Sanyiwa A, Mohn A, Chiarelli F.
Institute: Department of Pediatrics, University of Chieti, Chieti, Italy.
Source: Diabetes Care. 2007 Sep;30(9):2187-92.

OBJECTIVE: The purpose of this study was to assess glycemic control and complications of type 1 diabetes in children and adolescents in Tanzania.

RESEARCH DESIGN AND METHODS: This demographic and clinical survey included 99 children aged between 5 and 18 years attending Muhimbili National Hospital Clinic for Diabetes. A structured questionnaire was used for evaluating socioeconomic data and for estimation of the prevalence of acute complications occurring over the last 6 months. The prevalences of retinopathy and diabetic nephropathy were determined by fundus ophthalmoscopy and by microalbuminuria, respectively.

RESULTS: All of these children were treated with a conventional insulin regimen. The mean +/- SD duration of diabetes was 4.76 +/- 3.58 years. Only 1 child (1%) had good glycemic control (A1C <7.5%), 60 children (60.6%) had moderate glycemic control (A1C 7.5-10%), 14 children (14.1%) had poor glycemic control (A1C >10-12.5%), and 24 children (24.2%) had very poor glycemic control (A1C >12.5%). At onset of diabetes, 75% of children presented with diabetic ketoacidosis (DKA); 89 children (89.80%) had at least one episode of DKA, and 55 children (55.67%) had symptomatic hypoglycemic episodes. Microalbuminuria was present in 29 (29.3%) and retinopathy in 22 (22.68%) children.

CONCLUSIONS: Although there are some methodological limitations, this survey highlights the difficulties of achieving good metabolic control and the high prevalence of acute and chronic complications in Tanzanian children with type 1 diabetes. These results clearly show that major efforts are needed to improve quality of care in children with type 1 diabetes in Tanzania.

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