PREDICTIVE FACTORS OF GOOD METABOLIC CONTROL IN CHILDREN WITH TYPE I DIABETES

Introduction: The management of children with type 1 diabetes has been revolutionized first by the discovery of insulin and then by the development of new technologies. Nevertheless, the majority of patients still do not reach their glycemic target. The main objective of this study is to determine the predictive factors of good metabolic control in children with type I diabetes, in order to develop tailored approaches to improve the quality of management and prevent disease-related complications. Materials and Methods : Prospective analytical and descriptive study spread over 6 years from January 2015 to January 2021 including type 1 diabetic children diagnosed between 2015 and 2019 and followed up at the House Of The Young Diabeticin collaboration with the diabetes department of the childrens hospital (P2). Clinical and epidemiological data were obtained from patients medical records and the Free diab database. Results :The number of patients meeting the inclusion criteria was 542. A mean A1C in the target range was associated in bivariate analysis with patient age (p=0.003), parental socioeconomic and academic level (p=0.001), adhesion to health coverage (p=0.001), initial HbA1C value (p=0.001), number of self-monitoring of blood glucose (p=0.001), and treatment regimen (p=0.001). In multivariate analysis, the association was statistically significant for 5 parameters: socioeconomic level ( ß 0.10 95%CI 0.10-0.26 p 0.03), parents academic level (ß 0.15 95%CI 0.24-0. 5 p=0.002), adhesion to health coverage (ß 0.12 95%CI 0.18-0.46 p=0.001), initial A1C level (ß 0.16 95%CI 0.15-0.38 p<0.001) and number of self-monitoring of blood glucose (ß 0.46 95%CI 0.21-0.3 p<0.001). Conlusion: Our study demonstrates parameters related to good glycemic control that need to be taken into account to develop new management strategies for children with type 1 diabetes.